Journal of Conservative Dentistry
Home About us Editorial Board Instructions Submission Subscribe Advertise Contact e-Alerts Login 
Users Online: 1387
Print this page  Email this page Bookmark this page Small font sizeDefault font sizeIncrease font size

ORIGINAL ARTICLE Table of Contents   
Year : 2010  |  Volume : 13  |  Issue : 1  |  Page : 42-46
Remineralization potential of fluoride and amorphous calcium phosphate-casein phospho peptide on enamel lesions: An in vitro comparative evaluation

Department of Conservative Dentistry and Endodontics, Government Dental College, Thiruvananthapuram, India

Click here for correspondence address and email

Date of Submission05-Jun-2009
Date of Decision15-Aug-2009
Date of Acceptance07-Sep-2009
Date of Web Publication20-Apr-2010


Aim: This in vitro study was conducted on enamel blocks of human premolars with the aim of evaluating the remineralization potential of fluoride and ACP-CPP and the combination of ACP-CPP and fluoride on early enamel lesions.
Materials and Methods: Fifteen intact carious free human premolars were selected. The coronal part of each tooth was sectioned into four parts to make 4 enamel blocks. The baseline SMH (surface microhardness) was measured for all the enamel specimens using Vickers microhardness (VHN) testing machine. Artificial enamel carious lesions were created by inserting the specimens in demineralization solution for 3 consecutive days. The SMH of the demineralised specimens was evaluated. Then the four enamel sections of each tooth were subjected to various surface treatments , i.e. Group 1- Fluoride varnish, Group 2- ACP-CPP cream, Group 3- Fluoride + ACP-CPP & Group 4- Control (No surface treatment). A caries progression test (pH cycling) was carried out, which consisted of alternative demineralization (3hours) and remineralization with artificial saliva (21 hours) for five consecutive days. After pH cycling again SMH of each specimen was assessed to evaluate the remineralization potential of each surface treatment agent. Then, to asses the remineralization potential of various surface treatments at the subsurface level, each enamel specimen was longitudinally sectioned through the centre to expose the subsurface enamel area. Cross-sectional microhardness (CSMH) was evaluated to assess any subsurface remineralization
Results: Statistical analysis using one-way ANOVA followed by multiple comparisons test was applied to detect significant differences at P ≤ 0.05 levels between various surface treatments at different phases.
Conclusions: With in the limits, the present study concludes that; ACP-CPP cream is effective, but to a lesser extent than fluoride in remineralizing early enamel caries at surface level. Combination of fluoride and ACP-CPP does not provide any additive remineralization potential compared to fluoride alone. Fluoride, ACP-CPP and their combination are not effective in remineralizing the early enamel caries at the subsurface level.

Keywords: ACP-CPP; demineralization-remineralization; fluoride

How to cite this article:
Lata S, Varghese N O, 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

How to cite this URL:
Lata S, Varghese N O, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phospho peptide on enamel lesions: An in vitro comparative evaluation. J Conserv Dent [serial online] 2010 [cited 2023 Dec 8];13:42-6. Available from:

   Introduction Top

A carious lesion begins with the establishment of a combination of specific bacterial population, which is capable of demineralizing enamel under specific modified environment in the oral cavity. This demineralization is clinically manifested as a white, opaque spot particularly when air-dried.

In a neutral environment, the hydroxyapatite of the enamel is in equilibrium with saliva which is saturated with calcium and phosphate ions. [1] At or below pH 5.5, H + ions produced by the bacterial metabolites react preferentially with the phosphate group of the enamel crystals, converting PO4 2- ion to (HPO4) 2- ion which, once formed, can no more form the crystal lattice; at the same time H + ions are buffered. This leads to enamel dissolution, termed as demineralization, which marks the beginning of early enamel caries. [2],[3]

However, the demineralization can be reversed if the pH is neutralized and there are sufficient calcium and phosphate ions available in the immediate environment. This enables the rebuilding of partly dissolved apatite crystals. This is called as remineralization. To restore the natural equilibrium, either remineralization must be enhanced or demineralization must be retarded. The early enamel lesions have a potential for remineralization, with an increased resistance to further acid challenge, particularly with the use of enhanced remineralization treatments.

Fluoride is the most commonly used remineralizing agent. When the acid attacks the enamel surface, the pH begins to rise and fluoride present in the microenvironment causes enamel dissolution to stop.

As the pH rises, new and larger crystals that contain more fluoride (fluorhydroxyapatite) form, thereby, reducing the enamel demineralization by forming fluorhydroxyapatite crystals and enhancing remineralization. Normally, remineralization by fluoride is a self-limiting surface phenomenon that prevents penetration of ions into the depth of the lesion. [4] Rapid deposition of fluorapatite forms a firm surface layer, which is more resistant to further demineralization. However, at the same time, it is resistant to penetration of calcium and phosphate ions required to rebuild the lesion in depth.

A new remineralization technology based on phosphopeptide from milk protein casein has been developed. The casein phosphopeptides (CPP) contain multiphosphoseryl sequences with the ability to stabilize calcium phosphate in nanocomplexes in solutions like amorphous calcium phosphate (ACP). Through their multiple phosphoseryl sequences, CPP binds to ACP in metastable solution preventing the dissolution of calcium and phosphate ions. The ACP-CPP also acts as reservoir of bio-available calcium and phosphate, and maintains the solution supersaturated, thus facilitating remineralization. [5] Studies report that unlike fluoride, ACP-CPP has been shown to remineralize enamel subsurface and subsurface lesion in vivo and in vitro. [6],[7] It is expected that combination of fluoride and ACP-CPP would give enhanced remineralization compared to individual application of fluoride and ACP-CPP. This in vitro study aims to evaluate the remineralization potential of fluoride varnish, ACP-CPP, and combination of fluoride +ACP-CPP on early enamel lesions.

   Materials and Methods Top

The materials used in the study;

  1. Fluoride varnish (Fluorprotector Intro pack; Ivaclar Vivadent)
  2. Amorphous calcium phosphate- Casein phosphopeptide (CPP-ACP) GC Tooth Mousse, Recaldent; GC Corp; Japan

Fifteen premolars extracted from patients ranging in the age group of 14-20 years, for orthodontic purpose, were collected and the radicular part of each tooth was removed. The coronal part of each tooth was then longitudinally sectioned bucco-lingually and mesio-distally into four sections using a high speed diamond tipped disc. Four enamel specimens were prepared. Custom made plastic cylindrical molds were made and self cured acrylic resin was poured on it; then each enamel block was embedded in, on top of partially set, and allowed to set. An acid resistant nail varnish was applied around the exposed enamel surface leaving a window of 3 mm Χ 3 mm of enamel exposed at the centre.

Lieca Japan, Tokyo, Vickers micro hardness tester was used to evaluate micro hardness. A load of 25 grams was applied, for five seconds, for all the specimens. The micro hardness numbers (VHN) of five indentations at spacing of 100 microns were taken and the average value was considered the mean base line micro hardness (SMH) of the corresponding specimen. The objective of base line surface micro-hardness determination is to compare and calculate the changes that occur after induction of enamel lesions and after pH cycling.

Carious lesions representing preliminary stage of subsurface enamel demineralization were produced by suspending four sections of each tooth into glass tubes containing 20 ml of demineralization solution, for 72 hours, in an incubator at a temperature of 35 degree. [8] After induction of enamel lesions, all the specimens were evaluated for surface micro hardness measurements under 25 gram loads for five seconds duration.

The composition of the demineralizing solution was as follows;

CaCl 2 = 2.2 mM NaH 2 PO 4 = 2.2 mM Lactic acid = 0.05 M

Fluoride = 0. 2 ppm, Solution was adjusted with 50% NaOH to a pH 4.5

Four sections of each tooth were subjected to the following surface treatments,

Section 1- A thin layer of fluoride varnish was applied, allowed to be absorbed for 20 seconds and then air dried.

Section 2- A generous layer of ACP-CPP cream was applied by an applicator brush and left undisturbed for a minimum of three minutes.

Section 3- A thin layer of fluoride varnish was applied and allowed to be absorbed for 20 seconds. This was followed by a generous layer of ACP-CPP cream and left undisturbed for a minimum of three minutes.

Section 4- This served as the control group where no surface treatment was performed.

A pH cycling regimen included alternative demineralization (three hours) and remineralization (21 hours) for five consecutive days. For the demineralization phase, the demineralization solution used for the induction of enamel lesions was used and for the remineralization phase, a synthetic saliva preparation was carried out. [9]

The inorganic composition of synthetic saliva is similar to that of natural saliva. After pH cycling, again the surface micro hardness was assessed for all the specimens under 25-gram load for 5 seconds.

This composition of the synthetic saliva is as follows :

Na 3 PO 4 - 3.90 mM NaCl 2 - 4.29 mM KCl - 17.98 mM

CaCl 2 - 1.10 mM MgCl 2 - 0.08 mM H 2 SO 4 - 0.50 mM

NaHCO 3 - 3.27 mM, distilled water, and the pH was set at a level of 7. 2.

Each specimen was longitudinally sectioned into two halves through the center of the window. The cut surface was exposed and polished. A row of five indentations was made at approximately 100 microns below the enamel surface. All the sections were evaluated for the measurement of cross-sectional micro hardness (CSMH) which denoted the changes in micro hardness at subsurface level under the same parameter of load and time. Then the percentage of mineral recovery of the surface micro hardness values was determined by a formula,

% SMHR = Percentage of Surface Micro Hardness Recovery

   Results Top

Statistical analysis using one-way ANOVA followed by multiple comparisons test (multiple Duncan test)) was applied to detect significant differences at the level of p ≤ 0.05, between various surface treatments at different phases of study.

   Discussions Top

Clinically, the early enamel lesion appears white because the normal translucency of the enamel is lost. The surface becomes fragile and is susceptible to damage from probing. The most important feature of white spot lesion is the presence of relatively intact surface layer overlying subsurface demineralization (40-70%). Even though initial enamel lesions have intact surfaces, they have a low mineral content at the surface layer when compared to sound enamel; thus showing a lower hardness value at the surface than for sound enamel tissue. [10],[11]

Organic acids are produced by the metabolic activity of micro organisms in the bacterial plaque. These acids diffuse through the pellicle into the surface enamel. These acids attack the apatite crystals, particularly at the vulnerable lattice points where carbonate ions are present.

This causes Ca 2+ , OH - , PO4 2- , F - , CO3 - , Na + and Mg 2+ to be removed from the crystal lattice and to diffuse into the solution phase between the crystals. The dissolving calcium ions and phosphate ions form various calcium phosphate salts that either diffuse to the exterior or provide an environment that facilitates the repair of the faulty crystallites beneath the surface of enamel facilitating remineralization. [12] Mineral loss or demineralization proceeds as long as sufficient acid is available. As more enamel dissolves, concentration of the Ca ion and PO 4 ion increases.

As calcium and phosphate ions diffuse outwards, remineralization at the surface becomes more and more likely. This leads to the formation of an apparently intact enamel surface layer about 20-40 microns where the mineral content is higher than the body of the lesion.

In the present study, the specimens kept in the demineralization solution (CaCl 2 , NaH 2 PO 4 , Lactic acid and Fluoride) for 72 hours at 37΀ C created a subsurface demineralization of approximately 150 microns width with an intact surface simulating an early enamel lesion. [13] The concentration of both calcium and phosphates, in the demineralization solution, was at 50% of saturation level, causing dissolution of only enamel subsurface. Addition of fluoride prevented surface demineralization by forming fluorapatite at the surface, which simulated the naturally occurring early enamel lesions having intact surface layer.

Considering the importance of the surface layer in caries progression, the evaluation of changes in this region is relevant. Surface micro hardness (SMH) measurement is a suitable technique for this purpose. Micro hardness measurement is appropriate for a material having fine microstructure, non-homogenous or prone to cracking like enamel. Surface micro hardness indentation provides a relatively simple, non-destructive and rapid method in demineralization and remineralization studies. Therefore, in the present study, the micro hardness values for each specimen were measured in three steps; the base line micro hardness, after induction of carious lesion (demineralization) and after pH cycling.

The values (VHN) obtained during the initial base line micro hardness measurements in the present study were in the range of VHN 254 - 363, which satisfies the VHN range of normal enamel tissue. [14] The surface micro hardness values for each group of the enamel specimens were decreased to 162-183 at the end of 72 hours of demineralization [Table 1] which is in accordance with the study conducted by Maupome et al. [15]

The period for demineralization in the pH cycling phase is for three hours, which was to simulate the duration of demineralization (low cariogenic challenge) that occurs in the oral cavity. [16] The test material was applied on enamel blocks twice a day s to simulate the normal recommended daily oral prophylaxis. In the present study, after the pH cycling phase the mean SMH (VHN) for Fluoride group 218.30, for ACP-CPP group 185.20, for Fluoride + ACP-CPP group 216.25 and for the control group 167.30 respectively. It indicates that combination of fluoride + ACP-CPP does not provide any additive remineralization potential when compared to fluoride varnish alone. The mean increase in SMH (VHN) for ACP-CPP treatment group is 185.20, which indicates that there is a significant increase in micro hardness. Therefore, ACP-CPP can also aid in remineralization, [17],[18],[19],[20],[21] but not as effectively as fluoride or fluoride and ACP-CPP group combination.

Moreover, in the fluoride + ACP-CPP treatment group, the fluoride varnish was applied first followed by the application of ACP-CPP over the enamel specimens. It is speculated that the results obtained in fluoride + ACP-CPP group reflect the results similar to fluoride varnish and hence might have hindered the effect of ACP-CPP. The varnish applied evaporated quickly to form a thin film on surface. The ACP-CPP group, being creamy in consistency, could not properly wet the surface.

It is speculated that most of the ACP-CPP cream was lost after washing in distilled water. The percentage of surface micro hardness recovery was calculated for all surface treatment groups, which showed greatest recovery for the fluoride + ACP-CPP group (35%) followed by fluoride (32%), followed by ACP-CPP (17%) [Graph 1]. There was no regain in micro hardness in the control group giving a negative sign (-14%). The difference in the percentage micro hardness recovery in fluoride group and fluoride +ACP-CPP group was not statistically significant.

The mean CSMH (VHN) values obtained were: 148.87 (fluoride group), 150.63 (ACP-CPP), 155.51(fluoride + ACP-CPP) and 143.75 (control group) [Table 2]. It indicates that there is no increase in micro hardness at the enamel subsurface, which is not in accordance with the previous studies. There is no remineralization at subsurface level and all the treatment groups failed to remineralize the subsurface lesion in depth. Nevertheless, fluoride, fluoride + ACP-CPP and to a lesser extent ACP-CPP can remineralize the surface lesion. There was no increase in CSMH at the subsurface level and the values suggested that, that none of the surface treatment agents could penetrate the demineralized enamel at the subsurface level. The reason could be; fluoride ions and ACP-CPP were not able to penetrate the subsurface enamel area, the in vitro set up is not exactly mimicking the in vivo conditions occurring in the mouth, duration of the experimental set up (seven days) is too short.

[Additional file 1]

   Conclusions Top

Within the limits, the present study concludes that; Fluoride varnish is effective in remineralizing the early enamel caries at the surface level. ACP-CPP cream is effective, but to a lesser extent than fluoride varnish in remineralizing early enamel caries at surface level. Combination of fluoride varnish and ACP-CPP does not provide any additive remineralization potential when compared to fluoride varnish alone at the surface level. Fluoride varnish, ACP-CPP cream and combination of fluoride varnish and ACP-CPP are not effective in remineralizing the early enamel caries at the subsurface level. However, one must bear in mind that remineralization in vitro may be quite different when compared to dynamic complex biological system which usually occurs in oral cavity in vivo. Thus, direct extrapolations to clinical conditions must be exercised with caution because of obvious limitations of in vitro studies.

   Acknowledgment Top

I am extremely thankful to Dr. P.R. Harikrishna Varma, Scientist in charge and Dr. Manoj Komath, Scientist, Bio Ceramics Laboratory, BMT Wing, Sri Chithra Thirunal Institute of Medical Sciences and Technology, Thiruvananthapuram, for their valuable interactions and suggestions. I wish to put on record my gratitude to them for providing the Vickers hardness testing machine for this study and extending the laboratory facilities.

   References Top

1.Silverstone LM, Hicks MJ, MJ Featerstone. Dynamic factors affecting lesion initiation and progression in human dental enamel, 2 Surface morphology of sound enamel and caries like lesions of enamel. Quintessence Int 1988;19:773-85.  Back to cited text no. 1      
2.Marsh PD. The oral microflora and biofilm on the teeth. In: Fejerskov O, Kidd E, editors. Dental caries: The disease and its clinical management. Oxford (UK): Blackwell and Munksgaard; 2003. p. 29-47.  Back to cited text no. 2      
3.Larsen MJ. Dissolution of enamel. Scand J Dental Research1973;81:518-22.  Back to cited text no. 3      
4.Ten Cate JM "in vitro" studies on the effects of fluoride on de and remineralization (special issue) J Dental Research 1990;69:614-9.  Back to cited text no. 4      
5.Reynolds EC. Additional aids to remineralization of the tooth structure. In: Mount GJ, Hume WR, editors. Preservation and restoration of tooth structure. 2nd ed. Brisbane Australia: Knowledge Books and Software; 2005. p. 111-8.  Back to cited text no. 5      
6.Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide -stabilized calcium phosphate solutions. J Dental Res 1997;76:1587-95.  Back to cited text no. 6      
7.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.  Back to cited text no. 7      
8.Ivancakova R, Hogan MM, Harless JD, Wefel JS. Effect of fluoridated milk on progression of root surface lesions in vitro under pH cycling conditions. Caries Research 2003;37:166-71.   Back to cited text no. 8      
9.Sato Y, Sato T, Niwa M, Aoki H. precipitation of octa calcium phosphates on artificial enamel in artificial saliva. J Mater Sci Mater Med 2006;17:1173-7.  Back to cited text no. 9      
10.Koulourides T, Feagin F, Pigman W. Remineralization of dental enamel by saliva in vitro. Ann NY Acad Sci 1965;131:751-7.  Back to cited text no. 10      
11.Arend J, Ten Cate JM. Tooth Enamel remineralization. J Crystal Growth 1981;53:135-47.   Back to cited text no. 11      
12.Featherstone JD, Ten Cate JM, Shariati M, Arends J. Comparison of artificial caries-like lesions by quantitative microradiography and micro hardness profiles. Caries Res 1983;17:385-91.  Back to cited text no. 12      
13.Featherstone JD, Shariati M, Brugler S, Fu J, White DJ. Effect of an anticalculus dentifrice on lesion progression under pH cycling conditions in vitro. Caries Research 1988;22:337-41.  Back to cited text no. 13      
14.Ryge G, Foley DE, Faorhurst CW. Micro-indentation hardness. J Dental Research 1961;40:1116-26.  Back to cited text no. 14      
15.Maupomι G, Aguilar-Avila M, Medrano-Ugalde H, Borges-Yαρez A. In vitro quantitative micro hardness assessment of enamel with early salivary pellicles after exposure to an eroding cola drink. Caries Res 1999;33:140-7.  Back to cited text no. 15      
16.Ten Cate JM, Duijsters PP. Alternating demineralization and remineralization of artificial enamel lesions. Caries Res 1982;16:201-10.   Back to cited text no. 16      
17.Reynolds EC, Black CL, Cai F, Cross KJ, Eakins D, Huq NL, et al. Advances in enamel remineralization: Casein phosphopeptide Amorphous calcium phosphate. J Clin Dent 1999;10:86-8.   Back to cited text no. 17      
18.Shen P, Cai F, Nowicki A, Vincent J, Reynold EC. Remineralization of enamel subsurface lesions by sugar free chewing gum containing casein phosphopeptide - amorphous calcium phosphate. J Dental Res 2001;80:2066-70.  Back to cited text no. 18      
19.Iijima Y, Cai F, Shen P, Walker G, Reynolds C, Reynolds EC. Acid resistance of enamel subsurface lesions remineralized by a sugar free chewing gum containing casein phosphopeptide -amorphous calcium phosphate. Caries Res 2004;38:551-6.  Back to cited text no. 19      
20.Manton DJ, Shen P, Cai F, Chioncrane NJ, Reynolds C, Messer LB. 0185 Remineralization of white spots lesions in situ by tooth mousse. Sequence no-17- Demineralization/Remineralization, 28 June 2006 Brisbane convention and exhibition centre, cariology research programme. [last accessed on 2007 May 1].  Back to cited text no. 20      
21.Christos and Vougioklakisg.; Effect of a commercial paste based on CPP-ACP complex on the demineralization of sound human dentine and on remineralization potential of artificial caries-like lesions. Caries Res 2007;35:695-8.  Back to cited text no. 21      

Correspondence Address:
S Lata
Department of Conservative Dentistry, GITAM Dental College and Hospital, Visakhapatnam (A.P)
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-0707.62634

Rights and Permissions


  [Table 1], [Table 2]

This article has been cited by
1 In vitro determination of the remineralizing potential and cytotoxicity of non-fluoride dental varnish containing bioactive glass, eggshell, and eggshell membrane
E. Durmus, T. Kölüs, E. Çoban, H. Yalçinkaya, H. E. Ülker, I. Çelik
European Archives of Paediatric Dentistry. 2023;
[Pubmed] | [DOI]
2 Mimicking amelogenesis to remineralize enamel through co-assembly of PTL fibrils and CMC/ACP
Yangyang Ye, Runqiu Lu, Hao Ren, Yang Yang, Tianqi Li, Xiangyu Zhang, Peng Yang, Xu Zhang
Materials & Design. 2023; : 111654
[Pubmed] | [DOI]
3 Laser – fluorescence based evaluation of remineralization in artificial enamel lesions using three commercially available re-mineralizing agents – An invitro study
Sukhbir Kour, Azhar Malik, Trishagni Choudhary, Ajay Kumar, Pradeep P R, Rachna Dhani
IP Indian Journal of Conservative and Endodontics. 2023; 8(2): 97
[Pubmed] | [DOI]
4 Comparison of therapies of white spot lesions: a systematic review and network meta-analysis
Zunxuan Xie, Lei Yu, Sining Li, Jianing Li, Yuyan Liu
BMC Oral Health. 2023; 23(1)
[Pubmed] | [DOI]
5 Comparative Evaluation of the Remineralization Potential of Fluoride-containing Toothpaste, Honey Ginger Paste and Ozone. An In Vitro Study
Shweta Chaudhary, Rohan Shah, Alok Patel, Smita Patil, Amol Kamble, Kimaya K Kade
International Journal of Clinical Pediatric Dentistry. 2023; 15(5): 541
[Pubmed] | [DOI]
6 Remineralization Potential of a Combination of Chitosan with Nanohydroxyapatite and a Self-assembling Peptide with Nanohydroxyapatite: An In Vitro Study
Ridyumna Garain, Krishnakumar Gollahalli Rangappa, Zeeshan Heera Ahmad, Komal Jain, Ramakrishna Arroju, Vedavathi Boregowda
The Journal of Contemporary Dental Practice. 2023; 23(12): 1255
[Pubmed] | [DOI]
7 Assessment of the Remineralizing Efficacy of Grape Seed Extract vs Sodium Fluoride on Surface and Subsurface Enamel Lesions: An In Vitro Study
Haithem Milad Hameed, Aya Adel El Tahlawy, Sayed Hussein Saniour
The Journal of Contemporary Dental Practice. 2023; 23(12): 1237
[Pubmed] | [DOI]
8 Evaluation of Remineralization Potential of Natural Substances on Artificially Induced Carious Lesions in Primary Teeth: An In Vitro Study
Kavitha Ramar, Pooja V Ravi, Rajakumar Sekar
International Journal of Clinical Pediatric Dentistry. 2023; 16(2): 244
[Pubmed] | [DOI]
9 Effect of Different Remineralization Agents on Artificial Caries Lesion: An in-vitro Study
Clinical and Experimental Health Sciences. 2023;
[Pubmed] | [DOI]
10 Comparative Evaluation of the Depth of Remineralization with Casein Phosphopeptide-Amorphous Calcium Phosphate, Sodium Fluoride with CXP, Nano-Hydroxyapatite, and Sodium Fluoride on Artificially Demineralized Lesions using Stereomicroscope: An In vitro St
Gaurav Anand Rane, B. Sandhyarani, Anil T. Patil, Kunal Keshaw, Anita Raikar, Rucha Davalbhakta
Journal of Indian Association of Public Health Dentistry. 2023; 21(2): 118
[Pubmed] | [DOI]
11 Estimation of the Efficacy of Remineralizing Agents on the Microhardness of Deciduous Teeth Demineralized Using Pediatric Formulations
Amith Adyanthaya, Malini Venugopal, T Nishna, Ann Meera Johnson, Jipsa Venugopal, RV Anju
The Journal of Contemporary Dental Practice. 2023; 24(5): 325
[Pubmed] | [DOI]
12 Carboxymethyl Chitosan—Fluoride-doped Amorphous Calcium Phosphate: A Novel Remineralizing Gel
Shruti B Nimbeni, Basavaraj S Nimbeni, Darshan D Divakar, Mohammad Samiullah
International Journal of Clinical Pediatric Dentistry. 2023; 16(5): 748
[Pubmed] | [DOI]
13 A Comparative Evaluation of Remineralizing Potential of Commonly Used Fluoridated Toothpaste, Herbal Toothpaste, Toothpaste with Zinc Hydroxyapatite, and Toothpaste with Calcium Sucrose Phosphate in Children: A Scanning Electronic Microscopic Study
Shivayogi M Hugar, Niraj Gokhale, Chaitanya Uppin, Seema Hallikerimath, Sanjana P Soneta, Riddhi Shripad Joshi
International Journal of Clinical Pediatric Dentistry. 2022; 15(S2): S158
[Pubmed] | [DOI]
14 Evaluation of Remineralizing Potential of CPP-ACP, CPP-ACP + F and ß TCP + F and Their Effect on Microhardness of Enamel Using Vickers Microhardness Test: An In Vitro Study
Malay Mitra, Manish Jha, Deepa V Bhat, Kiran L Awchat, Pooja Singh, Kashika Arora
International Journal of Clinical Pediatric Dentistry. 2022; 15(S2): S221
[Pubmed] | [DOI]
15 Comparison of Remineralization Potential of Casein Phosphopeptide: Amorphous Calcium Phosphate, Nano-hydroxyapatite and Calcium Sucrose Phosphate on Artificial Enamel Lesions: An In Vitro Study
Divya Reddy, Umme Azher, Santhosh T Paul, Ronin Sebastian
International Journal of Clinical Pediatric Dentistry. 2022; 15(1): 69
[Pubmed] | [DOI]
16 Advances in the Management of Dentin Hypersensitivity: An Updated Review
Van Viet Dam, The Hanh Nguyen, Hai Anh Trinh, Da Thi Dung, Trinh Dinh Hai
The Open Dentistry Journal. 2022; 16(1)
[Pubmed] | [DOI]
17 Comparative evaluation of efficacy of bioactive glass, tricalcium phosphate, and ozone remineralizing agents on artificial carious lesion
Debkant Jena, Abhigyan Manas, CH Venkateswararao, MohamedTharwat Salama, PrabuMahin Syed Ismail, ShaikRiyaz Basha
Journal of Pharmacy And Bioallied Sciences. 2022; 14(5): 959
[Pubmed] | [DOI]
18 Impact of Fluoride Varnishes on Enamel Surface Microhardness of Primary Teeth: An In Vitro Study
Uthman S Uthman
World Journal of Dentistry. 2022; 13(5): 469
[Pubmed] | [DOI]
19 Cultivation of Lactic Acid Bacteria and Evaluation of the Antimicrobial Potential of Partially Purified Bacteriocin-like Inhibitory Substances against Cariogenic and Food Pathogens
Amanda Romana Santos da Silva, Pamela Oliveira de Souza de Azevedo, Attilio Converti, Ricardo Pinheiro de Souza Oliveira
Fermentation. 2022; 8(8): 400
[Pubmed] | [DOI]
20 Comparative assessment of enamel remineralisation on the surface microhardness of demineralized enamel - an in vitro study
Bhavika Bhavsar, Mary Vijo, Pranjely Sharma, Tulika Patnaik, Mohammad Khursheed Alam, Santosh Patil
PeerJ. 2022; 10: e14098
[Pubmed] | [DOI]
21 Evaluating changes in the color and luminosity of dental enamel after orthodontic treatment: A clinical study
Lucineide Lima dos Santos, Sandrine Bittencourt Berger, Thais Maria Freire Fernandes, Flaviana Alves Dias, Murilo Baena Lopes, Paulo Henrique Perlatti D’Alpino, Alcides Gonini-Júnior, Ricardo Danil Guiraldo
Brazilian Dental Journal. 2022; 33(6): 78
[Pubmed] | [DOI]
22 Efficacy of a Novel Bioactive Glass-Polymer Composite for Enamel Remineralization following Erosive Challenge
Farnoosh Fallahzadeh, Soolmaz Heidari, Farhood Najafi, Maryam Hajihasani, Nooshin Noshiri, Neda F. Nazari, Boonlert Kukiattrakoon
International Journal of Dentistry. 2022; 2022: 1
[Pubmed] | [DOI]
23 Remineralizing Potential of Milk and GC Tooth Mousse on Demineralized Human Enamel: An In Vitro Comparative Evaluation
Vabitha Shetty, Srikala Bhandary, Ishani Vakil
Journal of Health and Allied Sciences NU. 2022;
[Pubmed] | [DOI]
24 Assessment of White Spot Lesion and Enamel Demineralization in Orthodontic Patients With Fixed Brackets—A Clinical Appraisal Using Fluoride Mouth Rinse, Fluoride Varnish Containing CPP-ACP, and CPP-ACFP
Sumeet Mishra, Shubhangi Mani, Aishwarya Sonawane, Prashant Viragi, N. G. Toshniwal, Ravindra Manerikar
Journal of Indian Orthodontic Society. 2022; : 0301574222
[Pubmed] | [DOI]
25 Novel trends, challenges and new perspectives for enamel repair and regeneration to treat dental defects
Fatemeh Mohabatpour, Xiongbiao Chen, Silvana Papagerakis, Petros Papagerakis
Biomaterials Science. 2022;
[Pubmed] | [DOI]
26 Remineralization of early enamel lesions with a novel prepared tricalcium silicate paste
Kareem Hamdi, Hamdi H. Hamama, Amira Motawea, Amr Fawzy, Salah Hasab Mahmoud
Scientific Reports. 2022; 12(1)
[Pubmed] | [DOI]
27 Effect of the nano-fluorapatite ceramic particles on mechanical behavior of fluoride varnishes
Yeganeh Moayedee, Iman Mobasherpour, Sara Banijamali, Mansour Razavi, Nader Nezafati
Materials Chemistry and Physics. 2022; : 126421
[Pubmed] | [DOI]
28 The micro-shear bond strength of resin cements to aged laser bleached enamel after using different desensitizing agents
Aya E. Samaha, Ahmad K. ElFadl, Mohammed N. Anwar
Clinical and Experimental Dental Research. 2021;
[Pubmed] | [DOI]
29 A comparative evaluation of penetration depth and surface microhardness of Resin Infiltrant, CPP-ACPF and Novamin on enamel demineralization after banding: an in vitro study
Nishita Rana, Namita Singh, Shaila, Abi. M. Thomas, Rajan Jairath
Biomaterial Investigations in Dentistry. 2021; 8(1): 64
[Pubmed] | [DOI]
30 Remineralization Potential and Shear Bond Strength of Surface Treated Hypomineralized Enamel in Bonding of Orthodontic Brackets: An In Vitro Study
EnasTawfik Enan, Marwa Ali Tawfik, Rabab Mehesen, Sakeenabi Basha
Journal of Advanced Oral Research. 2021; 12(1): 127
[Pubmed] | [DOI]
31 A Comparison between Two Different Remineralizing Agents against White Spot Lesions: An In Vitro Study
Hassan Alsubhi, Mohammad Gabbani, Abdulsalam Alsolami, Mohammed Alotaibi, Jameel Abuljadayel, Waleed Taju, Omair Bukhari, Boonlert Kukiattrakoon
International Journal of Dentistry. 2021; 2021: 1
[Pubmed] | [DOI]
32 A Novel Strategy for Caries Management: Constructing an Antibiofouling and Mineralizing Dual-Bioactive Tooth Surface
Li Zhou, Quan Li Li, Hai Ming Wong
ACS Applied Materials & Interfaces. 2021; 13(26): 31140
[Pubmed] | [DOI]
33 The effect of Remin Pro on the microhardness of initial enamel lesions in primary teeth: An in vitro study
Homa Nourolahian, Iman Parisay, Fatemeh Mir
Dental Research Journal. 2021; 18(1): 16
[Pubmed] | [DOI]
34 Comparative evaluation of the spectral-domain optical coherence tomography and microhardness for remineralization of enamel caries lesions
Dental Materials Journal. 2021; 40(5): 1115
[Pubmed] | [DOI]
35 Avian Eggshell Slurry as a Dentin Desensitizing Agent: An In Vitro Assessment Using Two Techniques
Aya A El Tahlawy, Dalia A Saba, Nahed G Bakir
The Journal of Contemporary Dental Practice. 2021; 22(5): 532
[Pubmed] | [DOI]
36 Calcium Release from Different Toothpastes after the Incorporation of Tricalcium Phosphate and Amorphous Calcium Phosphate
Ping-Jen Hou, Chang-Yu Lee, Keng-Liang Ou, Wen-Chien Lan, Yen-Chun Chuo, Hung-Yang Lin, Hsiao-Wei Chao, Bai-Hung Huang, Takashi Saito, Hsin-Yu Tsai, Tzu-Sen Yang, Christopher J. Walinski, Muhammad Ruslin
Applied Sciences. 2021; 11(4): 1848
[Pubmed] | [DOI]
37 Comparing Impact of Two Resin Infiltration Systems on Microhardness of Demineralized Human Enamel after Exposure to Acidic Challenge
Ebaa Alagha, Mustafa Ibrahim Alagha
Open Access Macedonian Journal of Medical Sciences. 2021; 9(D): 92
[Pubmed] | [DOI]
38 An In Vitro Evaluation of Remineralization Potential of Functionalized Tricalcium Phosphate Paste and CPP-ACPF on Artificial White Spot Lesion in Primary and Permanent Enamel
Shilpy Singla, Satish Maran, Neha Bhadoria, Mohit K Gunwal, Rinky Kukreja, Shashikiran N Devendrappa
International Journal of Clinical Pediatric Dentistry. 2021; 13(6): 579
[Pubmed] | [DOI]
39 Preparation of a toothpaste containing theobromine and fluoridated bioactive glass and its effect on surface micro-hardness and roughness of enamel
Imran FAROOQ, Abdul Samad KHAN, Imran Alam MOHEET, Emad ALSHWAIMI
Dental Materials Journal. 2021; 40(2): 393
[Pubmed] | [DOI]
40 Assessment of Remineralization Capacity of Various Remineralizing Agents on Artificial Enamel Lesions Using Confocal Laser Scanning Microscope: An In Vitro Study
Ateet Kakti, Nitin K Singh, Abhinav K Singh, Subhasmita Bhol, Mayakkannan Senthil Kumar, Mohanraj Madhumitha
The Journal of Contemporary Dental Practice. 2021; 22(3): 237
[Pubmed] | [DOI]
41 A Comparative Evaluation of Remineralizing Potential of Three Commercially Available Remineralizing Agents: An In Vitro Study
Vidya Manoharan, Anjana Gopalakrishnan, Muralikrishnan Balachandran, Amrutha Joy, Darshana Vinod, Saravanakumar M Subramani
International Journal of Clinical Pediatric Dentistry. 2020; 13(1): 61
[Pubmed] | [DOI]
42 Effectiveness of Various Dental Varnishes in Prevention of Enamel Demineralization around Orthodontic Brackets: An In Vitro Study
George Sam, Hosam Ali Baeshen, Dharmesh H Shivananda, Waseem Ansar, Abdul RN Dinsha, Sajai Bharath
The Journal of Contemporary Dental Practice. 2020; 21(6): 621
[Pubmed] | [DOI]
43 Effect of Toothbrushing on Surface Color of Ceramic-polymer Materials: An In Vitro Study
Kraig S Vandewalle, Farzan L Pouranfar, Ryan Sheridan, Cade Salmon
The Journal of Contemporary Dental Practice. 2020; 21(9): 1054
[Pubmed] | [DOI]
44 Novel CaF2 Nanocomposites with Antibacterial Function and Fluoride and Calcium Ion Release to Inhibit Oral Biofilm and Protect Teeth
Heba Mitwalli, Abdulrahman A. Balhaddad, Rashed AlSahafi, Thomas W. Oates, Mary Anne S. Melo, Hockin H. K. Xu, Michael D. Weir
Journal of Functional Biomaterials. 2020; 11(3): 56
[Pubmed] | [DOI]
45 Nanoparticles as Anti-Microbial, Anti-Inflammatory, and Remineralizing Agents in Oral Care Cosmetics: A Review of the Current Situation
Florence Carrouel, Stephane Viennot, Livia Ottolenghi, Cedric Gaillard, Denis Bourgeois
Nanomaterials. 2020; 10(1): 140
[Pubmed] | [DOI]
46 Determining the Efficacy of Three Potential Remineralizing Agents on Artificial Carious Lesions
Avula Jogendra Sai Sankar, Valluri Pratyusha Sai, Kakarla Pranitha, Muktineni Sridhar, Kundeti Siva Sankar, Adavikolanu Kesav Ramgopal
Journal of Oral Health and Community Dentistry. 2020; 14(1): 1
[Pubmed] | [DOI]
47 Effect of CO2 laser (10.6 µm) and Remin Pro on microhardness of enamel white spot lesions
Elahe Rafiei, Pooya Fadaei Tehrani, Soghra Yassaei, Alireza Haerian
Lasers in Medical Science. 2020; 35(5): 1193
[Pubmed] | [DOI]
48 The Effect of the Er:YAG Laser and MI Paste Plus on the Treatment of White Spot Lesions
Soghra Yassaei, Mohammad Nima Motallaei
Journal of Lasers in Medical Sciences. 2020; 11(1): 50
[Pubmed] | [DOI]
49 Application of near infrared spectroscopy with chemometrics for qualitative and quantitative dental caries assessment
Patteera Sodata, Jomjai Peerapattana
Vibrational Spectroscopy. 2020; 111: 103170
[Pubmed] | [DOI]
50 Comparative evaluation of the remineralizing potential of commercially available agents on artificially demineralized human enamel: AnIn vitro study
Chintan Joshi, Uma Gohil, Vaishali Parekh, Surabhi Joshi
Contemporary Clinical Dentistry. 2019; 10(4): 605
[Pubmed] | [DOI]
Sinta Puspita, Adioro Soetojo, Sri Kunarti
Conservative Dentistry Journal. 2019; 7(2): 130
[Pubmed] | [DOI]
52 Comparative Evaluation of Remineralizing Effect of Novamin and Tricalcium Phosphate on Artificial Caries: An in vitro Study
Guneet Guram, Umang Jagga, Uttam Paul, Arpita Kashyap, Vivek Padmanabhan, Kiran Keswani
The Journal of Contemporary Dental Practice. 2018; 19(1): 109
[Pubmed] | [DOI]
53 Effect of Two Remineralizing Agents on Initial Caries-like Lesions in Young Permanent Teeth: An in Vitro Study
Dalia AM Talaat, Ahmed AM Abdelrahman, Reham H Abdelaziz, Dina Nagy
The Journal of Contemporary Dental Practice. 2018; 19(10): 1181
[Pubmed] | [DOI]
54 Assessment of Enamel Surface Microhardness with different Fluoride Varnishes–An In Vitro Study
Roshan Uthappa, Civy V Pulayath, Siraj P Ismail, Shabna Moyin, Sameer Punathil, Shashit S Bavabeedu
The Journal of Contemporary Dental Practice. 2018; 19(11): 1317
[Pubmed] | [DOI]
55 Anticaries Efficacy of Liquorice Lollipop: An ex vivo Study
Gauri Krishnakumar, Dhananjaya Gaviappa, Shwetha Guruswamy
The Journal of Contemporary Dental Practice. 2018; 19(8): 937
[Pubmed] | [DOI]
56 Clinical Comparative Evaluation of Nd:YAG Laser and a New Varnish Containing Casein Phosphopeptides-Amorphous Calcium Phosphate for the Treatment of Dentin Hypersensitivity: A Prospective Study
Fady Bou Chebel, Carina Mehanna Zogheib, Nadim Z. Baba, Karim A. Corbani
Journal of Prosthodontics. 2018; 27(9): 860
[Pubmed] | [DOI]
57 Novel evaluation and treatment techniques for white spot lesions. An in vitro study
T. A. Bakhsh, A. S. Bakry, M. M. Mandurah, M. A. Abbassy
Orthodontics & Craniofacial Research. 2017; 20(3): 170
[Pubmed] | [DOI]
58 The effect of plasma treatment and bioglass paste on enamel white spot lesions
Noha A. El-Wassefy
The Saudi Journal for Dental Research. 2017; 8(1-2): 58
[Pubmed] | [DOI]
59 Effect of Casein Phosphopeptide–amorphous Calcium Phosphate and Calcium Sodium Phosphosilicate on Artificial Carious Lesions: An in vitro Study
Iqra Chaudhary, Abhay M Tripathi
International Journal of Clinical Pediatric Dentistry. 2017; 10(3): 261
[Pubmed] | [DOI]
60 Effect of Application of Remineralizing Agents on the Microhardness of Microabraded Teeth
S Srilatha, Zeeshan Hasanali Ladhani, Sayli Dargad, Vighnesh Dixit
World Journal of Dentistry. 2015; 6(3): 174
[Pubmed] | [DOI]
61 Effect of different preventive agents on bracket shear bond strength: in vitro study
Huda M Al-Kawari,Asma M Al-Jobair
BMC Oral Health. 2014; 14(1): 28
[Pubmed] | [DOI]
62 Remineralizing efficacy of different calcium-phosphate and fluoride based delivery vehicles on artificial caries like enamel lesions
Dina Elkassas,Abla Arafa
Journal of Dentistry. 2014;
[Pubmed] | [DOI]
63 The effect of a bioglass paste on enamel exposed to erosive challenge
Ahmed Samir Bakry,Hanadi Y. Marghalani,Omayma A. Amin,Junji Tagami
Journal of Dentistry. 2014;
[Pubmed] | [DOI]
64 Does acid etching enhance remineralisation of arrested white spot lesions?
S. N. Al-Khateeb,S. J. Tarazi,E. F. Al Maaitah,O. B. Al-Batayneh,E. S. J. Abu Alhaija
European Archives of Paediatric Dentistry. 2014;
[Pubmed] | [DOI]
65 Acquired pellicle as a modulator for dental erosion
Dusa Vukosavljevic,William Custodio,Marilia A.R. Buzalaf,Anderson T. Hara,Walter L. Siqueira
Archives of Oral Biology. 2014; 59(6): 631
[Pubmed] | [DOI]
66 Evaluation of the effect of PVA tape supplemented with 2.26% fluoride on enamel demineralization using microhardness assessment and scanning electron microscopy: In vitro study
Min Jung Kim,Sang Ho Lee,Nan Young Lee,In Hwa Lee
Archives of Oral Biology. 2013; 58(2): 160
[Pubmed] | [DOI]
67 The effect of zinc-carbonate hydroxyapatite versus fluoride on enamel surfaces after interproximal reduction
G. Alessandri Bonetti,E. Pazzi,M. Zanarini,S. Marchionni,L. Checchi
Scanning. 2013; : n/a
[Pubmed] | [DOI]
68 In vitro study of the effects of fluoride-releasing dental materials on remineralization in an enamel erosion model
San Ling Zhou,Jun Zhou,Shigeru Watanabe,Koji Watanabe,Ling Ying Wen,Kun Xuan
Journal of Dentistry. 2012; 40(3): 255
[Pubmed] | [DOI]
69 Casein phosphopeptide-amorphous calcium phosphate: a remineralizing agent of enamel
D Gurunathan,S Somasundaram,SA Kumar
Australian Dental Journal. 2012; 57(4): 404
[Pubmed] | [DOI]
70 Biofunctional Properties of Caseinophosphopeptides in the Oral Cavity
A.B. Nongonierma,R.J. FitzGerald
Caries Research. 2012; 46(3): 234
[Pubmed] | [DOI]
Min-Jung Kim,Sang-Ho Lee,Nan-Young Lee,Seung-Hyo Park
[Pubmed] | [DOI]
72 Remineralization effects of casein phosphopeptide-amorphous calcium phosphate crème on artificial early enamel lesions of primary teeth
International Journal of Paediatric Dentistry. 2011; 21(5): 374
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  

    Materials and Me...
    Article Tables

 Article Access Statistics
    PDF Downloaded1339    
    Comments [Add]    
    Cited by others 72    

Recommend this journal