Comparison of the newer preventive therapies on remineralisation of enamel in vitro

Aim of the Research: To investigate in vitro the effect of Tooth Mousse (10% w/v CPP-ACP), MI Paste Plus (10% w/v CPP-ACP, 900 ppm F) and high Fluoride concentration toothpaste (2800 ppm F) in the remineralisation of demineralised enamel subsurface lesions and to compare thses to the effect of 1450 ppm Fluoride toothpaste and non-fluoride (0 ppm F) toothpaste control. Materials and Methods: Enamel subsurface lesions were created in bovine enamel slabs (N=120) which were assigned randomly to five groups; (1) Fluoride-free Toothpaste (control), (2) 1450 ppm F toothpaste, (3) 2800 ppm F toothpaste, (4) 1450 ppm F toothpaste + Tooth Mousse (10% w/v CPP-ACP) and (5) 1450 ppm F toothpaste + MI Paste Plus (10% w/v CPP-ACP, 900 ppm F). The enamel slabs were subjected to a pH cycling regimen for 21 days, with daily exposure to the toothpastes solutions before and after the pH cycling, in 1450 ppm F toothpaste + Tooth Mousse and 1450 ppm F toothpaste + MI paste Plus groups the exposure to the Tooth Mousse or MI paste plus were performed after the last toothpaste exposure. QLF images were taken at the baseline and at the endpoint of the experiment. Data analysis was carried out using one-way analysis of variance (One way ANOVA). Following the completion of the study two enamel slabs were randomly selected from each group to carry out SEM analysis. Results: In all five groups, both ΔF (Average fluorescence loss) and ΔQ (multiplication of ΔF and area) values improved significantly within the same group after the treatment compared with the baseline values. In addition, the mean difference in ΔF of 0 ppm F toothpaste (control) was significantly lower than the mean difference in ΔF of the 1450 ppm F toothpaste, 1450 ppm F toothpaste + Tooth Mousse and the 1450 ppm F toothpaste + MI paste Plus groups (p < 0.05) but not significantly lower than the 2800 ppm F toothpaste group. Whereas the mean difference in ΔQ of 0 ppm F toothpaste group was significantly lower when compared with all other groups (p < 0.05). The SEM imaging revealed the presence of amorphous deposits only on the enamel surface of the1450 ppm F toothpaste + Tooth Mousse and the 1450 ppm F toothpaste + MI paste Plus groups . Conclusion: The remineralisation of enamel subsurface lesions was found in all groups with a statistically significant difference between all the test groups compared with the 0 ppm F control. The use of Tooth Mousse and MI paste Plus in conjunction with 1450 ppm F showed some increased efficacy in the remineralisation of enamel subsurface lesions, however this did not reach a significant level.