جستجوی مقالات مرتبط با کلیدواژه « cpp-acp » در نشریات گروه « پزشکی »

The purpose of this study was to investigate the effect of adding CPP-ACP into a daily-use toothpaste on the remineralization of enamel caries lesions. Thirty enamel blocks were obtained from bovine incisors. Each specimen was divided into three equal parts. One-third of each block was coated with varnish to serve as a sound control area, while the remaining two-thirds underwent a demineralization process. After demineralization, another one-third of the surface was varnished, leaving only one-third of the enamel to undergo remineralization. The enamel blocks were divided into three groups (n=10), according to the remineralization treatment applied as follows: Group 1: fluoride-containing toothpaste, Group 2: CPP-ACP-containing toothpaste, and Group 3: fluoride- and CPP–ACP–containing toothpaste.  Remineralization was assessed through the Vickers microhardness test at various depths (20, 50, 120 and 200 µm). The data were analyzed by ANOVA and LSD test, and P< 0.05 was considered statistically significant. There was a significant difference in remineralization efficacy between the groups at the depth of 20 µm (P 0.001). Pairwise comparisons revealed that the toothpaste containing both fluoride and CPP-ACP had a significantly greater microhardness than other experimental groups (P 0.05). No significant difference was observed between the study groups concerning microhardness at 50, 120 and 200 µm depths (P 0.05). CPP-ACP can serve as a suitable alternative to fluoride in daily-use toothpaste for enamel remineralization. The concurrent use of fluoride and CPP-ACP in toothpaste can generate a synergistic remineralizing effect at the enamel surface layer.

Statement of the Problem: 

The prevalence of non-carious dentin lesions is on the rise mainly due to improved life expectancy. Successful management of these lesions is often challenging, and given that dentin can be remineralized, adverse consequences due to progression of these lesions can be prevented or minimized as such.

This study aimed to assess the effect of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) and Remin-Pro remineralizing agents on dentin microhardness of non-carious dentin lesions.

This in vitro, experimental study evaluated 36 extracted sound human premolars. The teeth were decoronated at the cementoenamel junction. Enamel was removed, and dentin was exposed at the cervical third of the buccal surface. The primary microhardness of dentin was then measured. The teeth, standardized in terms of dentin microhardness, then underwent demineralization by acid etching and were subjected to microhardness test again. They were then randomized into three groups for treatment with CPP-ACP, Remin-Pro, and artificial saliva (control), and dentin microhardness was measured for the third time after treatment. Data were analyzed using ANOVA.

Within group comparisons showed a significant difference in microhardness at the three time points in all three groups (p< 0.005). Between-group comparisons revealed that the microhardness of the three groups was not significantly different at baseline or after demineralization. However, the microhardness of the three groups was significantly different after the intervention (p= 0.000). Pairwise comparisons revealed significantly higher microhardness in the CPP-ACP group than the other two groups (p= 0.003). Remin-Pro and the control groups were not significantly different in this respect (p= 0.340).

CPP-ACP can be used for remineralization of non-caries dentin lesions; however, Remin-Pro does not appear to be effective for this purpose.

 The preventive treatments of primary caries lesions are essential for preventing destructive damage to the tooth structure. One of the common treatments is the application of casein phosphopeptide-amorphous calcium phosphate (CCP/ACP) paste on the enamel surface. The aim of this study was to investigate the effect of different percentages of nano-bioactive glass (nBG) incorporation into synthesized CPP/ACP paste on the remineralization of demineralized enamel.

 In general, 24 extracted human intact premolar teeth were selected, and their crowns were removed for this purpose. Each crown was cut into two halves, and each half was considered as a sample. The samples were placed in a demineralizing solution at a pH rate of 4.6 for 8 hours, in artificial saliva for 1 hour, and again in a remineralizing solution at a pH rate of 7 for 15 hours. The pH cycling was performed for 14 days to demineralize the enamel surface. The samples were randomly divided into 3 groups (n=16), including G1 (without treatment), G2 (treated with synthesized CPP/ ACP paste containing 5% nanobioglass), and G3 (treated with synthesized CPP/ACP paste containing 10% nanobioglass). The paste was then placed directly on the surface of the demineralized enamel for 4 minutes (twice a day for 28 days). The samples were subjected to the Vickers microhardness test. Finally, data were analyzed using SPSS (version 19) and the analysis of variance and Tukey’s tests (α = 0.05).

 There was a significant difference between microhardness values in G1 and G2, as well as G1 and G3 (P<0.05). However, no statistically significant difference was observed between G2 and G3 (P>0.05).

 The results showed adding bioactive glass into synthetic CPP/ACP paste increases enamel remineralization in spite of the percentage of bioactive glass incorporation.

Laser diode irradiation, the use of fluoride varnish, and casein phosphopeptide-calcium amorphous phosphate (CCP-ACP) paste have been suggested as effective methods to increase the enamel resistance to decay. The present study aimed to investigate the effect of fluoride varnish, CPP-ACP paste, and diode laser radiation on the microhardness of demineralized enamel.

In this experimental study, 78 extracted human premolar teeth were selected and sectioned into two buccal and lingual halves. The samples were immersed in demineralization solution, and primary micro-hardness was measured. Thereafter, the samples were randomly assigned to six groups: control group, 5% fluoride varnish, CPP-ACP paste, diode laser (2W, 940nm) for 40 sec, laser combined with fluoride varnish, and CPP-ACP paste in combination with laser. The microhardness of the samples was measured again after different treatments. Data were analyzed in SPPS software (version 23) using repeated measures analysis of variance (RM ANOVA) (P<0.05).

There was no significant difference in the microhardness values among different groups (P<0.05). The comparison of the mean microhardness between before and after treatment for each group revealed a significant difference in the enamel microhardness only in the CPP-ACP paste (P=0.003) and diode laser (P=0.009) groups.

As evidenced by the results of this study, the use of fluoride varnish, CPP-ACP paste, and diode laser radiation did not increase the microhardness and remineralization of tooth enamel. Moreover, laser diode irradiation with the parameters used in this study does not enhance the remineralization effect of fluoride varnish and CPP-ACP paste.

Incorporation of calcium phosphate agents into fluoride varnishes might improve anticaries benefits. But when clinical results do not mirror this view, explanations remain unclear.

Our hypothesis is that better clinical outcomes are obtained from fluoride plus calcium phosphate varnishes when there is sustained, controlled release of mineralizing ions.

Calculations of ion activity products and putative mineral phases have been underutilized in assessing clinical outcomes of fluoride varnishes with calcium phosphate agents. In this study, a mineral phase comparison between a low-release varnish comprising functionalized tricalcium phosphate (fTCP) against a high-release varnish comprising casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) was made. These calculations revealed the predominance of hydroxyapatite, fluorapatite, and calcium fluoride formation for the varnish containing fTCP, whereas the varnish containing CPP-ACP produced the same minerals along with b-TCP and octacalcium phosphate. This hypothesis shows the mineral phases expected to form from fluoride plus calcium phosphate varnishes might bear on clinical outcomes.

Background:

 Dental caries occurs due to the imbalance in the course of demineralization-remineralization in favor of demineralization. With remineralization, some signs of halted progression could be observed in the primary stages. The aim of this study is to in-vitro investigation of the effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP), fluoride varnish, and fluoride gel on the microhardness of the enamel of permanent teeth.

In this in vitro study, 344 specimens prepared from human premolars were randomly divided into four groups (n=86 specimens in each group). After preparing the specimens, the initial enamel value was first evaluated by Vickers microhardness technique. The specimens were immersed in a demineralizing solution and then treated with remineralizing compounds (I. Control, II. Fluoride varnish, III. Fluoride gel and IV. CPP-ACP). Microhardness values were re-measured at the end of demineralization and remineralization stages. The data were analyzed using SPSS software (version 16.0).

The results of the present study indicated a statistically significant difference in all groups in terms of initial enamel microhardness (0.288 ± 42.77), remineralization (0.213 ± 26.89), and demineralization values (0.167 ± 63.87) (p <0.001). Besides, there was a statistically significant difference in different groups in terms of remineralization values (p <0.001). In other words, the mean microhardness was 241.21 ±15.60 in Group III, 221.12 ± 75.69 in Group II, 211.16 ± 43.04 in Group IV, and 178.21 ± 63.9 in group- I.

Conclusion :

All remineralizing compounds resulted in enhanced microhardness of the enamel. Nevertheless, the fluoride-containing products showed greater potential in improving the level of microhardness and strength of the teeth compared to the compounds containing CPP-ACP.

This study evaluated the incorporation of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), calcium sodium phosphosilicate bioactive glass (BAG), chitosan (CH), and methacryloyloxydodecylpyridinium bromide (MDPB) on the compressive and flexural strength, fluoride (F‒ ) release, and bacterial adhesion of conventional glass-ionomer cement (C-GIC).

 Modifications were implemented by adding CPP-ACP, BAG, and CH to the glass powder, while MDPB-GIC was prepared by incorporating MDPB to the liquid of C-GIC. Custom-made molds were used for specimen preparation. Compressive and flexural strengths were evaluated using a universal testing machine. F‒ release was calculated with Erichrome cyanide reagent, using UV-spectrophotometry, at two time intervals of 24 hours and seven days. For bacterial adhesion, the test specimens were exposed to the bacterial suspension of Streptococcus mutans and Lactobacillus acidophilus for 4 hours, and the adherent bacteria were quantified using colorimetry as the optical density (OD).

The incorporation of MDPB increased the flexural strength of C-GIC, with no effect on its compressive strength. CH significantly improved the compressive and flexural strength; modifications with CPP-ACP, BAG, and MDPB significantly improved the flexural strength of C-GIC. While MDPB-GIC released significantly higher F‒ at 24 hours, CPP-ACP- and BAGmodified GICs were comparable to C-GIC on day 7. C-GIC exhibited the highest bacterial adhesion, and MDPB-GIC showed the least. The data were analyzed with one-way (ANOVA), and pairwise comparisons were made with Tukey HSD tests.

Hence, it can be concluded that the incorporation of CPP-ACP, BAG, and CH improved the mechanical properties of C-GIC, whereas MDPB improved the resistance of C-GIC to bacterial adhesion.

Plaque accumulation is the buildup of bacterial substances on dental surface. Plaque can be controlled using anti-bacterial chemicals such as acidulated phosphate fluoride (APF) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). The function of APF and CPP-ACP is to inhibit the growth and adhesion of bacterial plaque colonization by S. mutans on the tooth’s surface. This study aims to identify differences in the effectiveness of the topical application of APF gel and CPP-ACP paste against plaque accumulation in children. The research applied a quasi-experimentalmethod with a time-series design. The study was conducted at the Nur Hidayah and Ihsan Sakeena orphanages in Surakarta, where 30 children aged 6-12 were involved as research subjects, divided into two treatment groups namely the APF and CPP-ACP groups. Topical application of APF was given once on the first day, while that of CPP-ACP was administered once a day from the first until the seventh day. Plaque score data were obtained by PHP-M plaque score measurement. Total plaque scores were measured on day 1 before and after application, day 7 and day 14. Results show declining average plaque scores between the first day prior to topical application of APF and CPP-ACP and the fourteenth day afterwards. Independent samples tests reveal differences in effectiveness of topical APF gel and CPP-ACP paste application on plaque accumulation in children on day 7 and day 14, but no difference in plaque score change on day 1 ahead of and following application. Topical application of CPP-ACP paste decreases plaque accumulation in children more effectively than that of APF gel.