In-vitro investigation of remineralization efficacy of nanotechnological products and herbal-derived agents in primary teeth

Authors

DOI:

https://doi.org/10.5281/zenodo.7750177

Keywords:

Casein phosphopeptide-amorphous calcium phosphate, grape seed extract, nanohydroxyapatite, primary tooth, propolis, remineralization

Abstract

Objective: The objective of this study was to evaluate the remineralization efficacy of nanotechnological products including casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), nanohydroxyapatite (nHA), bioactive glass, and herbal agents, such as cocoa, propolis, grape seed extract, rosemary, and ginger, in the initial enamel caries of primary teeth.

Materials and methods: In this study, 80 primary tooth enamel samples were used and categorized into groups 1–10 as follows: intact enamel, caries group, CPP-ACP, nHA, bioactive glass, cocoa, propolis, grape seed extract, rosemary, and ginger. To create initial enamel caries, all groups except group 1 were placed in a demineralization solution for 72 hours and then subjected to pH cycling for 7 days. Except for groups 1 and 2, remineralization materials were applied to the teeth in the other groups for 4 minutes for 7 days. Scanning electron microscopy-energy dispersive X-ray (SEM/EDX) analysis was subsequently performed on all teeth. Statistical analyses were performed using Kruskal–Wallis, H test, Dunn, Tukey’s honestly significant difference, and one-way analysis of variance tests.

Results: Examination of the SEM images demonstrated that all remineralization materials formed calcified deposits on the enamel surface. EDX analysis revealed that, when Ca/P ratios were examined, there was a significant difference between the intact enamel group and the CPP-ACP group, and between the caries group and the CPP-ACP, nHA, bioactive glass and rosemary groups (p<0.05). No significant difference was noted between the remineralization materials (p>0.5).

Conclusions: All nanotechnological products and propolis, grape seed extract, cocoa butter, rosemary oil, and ginger oil showed remineralization activity in the initial caries of deciduous tooth enamel. Of all the remineralization groups, the grape seed extract group had the most homogeneous SEM image. CPP-ACP, nHA, bioactive glass, and rosemary increased the Ca/P ratio in enamel more than other remineralization materials.

References

US Department of Health and Human Services Oral Health Coordinating Committee. US Department of Health and Human Services oral health strategic framework, 2014–2017. Public Health Rep. 2016;131(2):242-57.

Uekusa S, Yamaguchi K, Miyazaki M, Tsubota K, Kurokawa H, Hosoya Y. Bonding efficacy of single-step self-etch systems to sound primary and permanent tooth dentin. Oper Dent. 2006;31(5):569-76.

Karabekiroğlu S, Ünlü N. The place and importance of early preventive practices in community-based preventive oral dental health programs. EÜ Dent Fac J. 2017;38(2):89-100.

Colak H, Dülgergil C, Dallı, M. American Academy on Pediatric Dentistry. Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. Pediatr Dent. 2011;30:40-3.

Do LG, Spencer AJ, Sawyer A, et al. Early childhood exposures to fluorides and child behavioral development and executive function: A population-based longitudinal study. J Dent Res. 2023;102(1): 28-36.

Betül K, Sezer B. Current remineralization agents in caries management. Turkey Klinikleri J Dent Sci. 2020;26(3):472-86.

Polat Y, Çelenk S. Overview of current fluorine-free remineralization materials and methods as an alternative to topical fluoride: an up-to-date. J Clin Trials Exp Investig. 2022;1(3):75-8.

Gümüş S. Evaluation of the effects of current remineralization agents on enamel with different methods. Doctoral thesis. Dicle University Faculty of Dentistry, 2021.

Lin PY, Wang J, Chuang TY, Chang YM, Chang HJ, Chi LY. Association between population-based fluoride varnish application services and dental caries experience among schoolchildren in Taiwan. J Formos Med Assoc. 2022;121(5):986-94.

Celik EU, Yazkan B, Katirci G. Treatment of initial caries lesions. Curr Res Dent Sci. 2011;21(1):48-56.

Cochrane NJ, Cai F, Huq NL, Burrow MF, Reynolds EC. New approaches to enhanced remineralization of tooth enamel. J Dent Res. 2010;89(11):1187-97.

American Academy of Pediatric Dentistry. Policy on early childhood caries (ECC): unique challenges and treatment options. The reference manual of pediatric dentistry. Chicago: American Academy of Pediatric Dentistry; 2021. p. 85-6.

Poureslami HR, van Amerongen WE. Early childhood caries (ECC): an infectious transmissible oral disease. Indian J Pediatr. 2009;76(2):191-4.

Yazan E, Gencay K, Tuna EB. The relationship between vaccine refusal and topical fluoride rejection. Selcuk Dent J. 2020;7(1):134-40.

Kamath P, Nayak R, Kamath SU, Pai D. A comparative evaluation of the remineralization potential of three commercially available remineralizing agents on white spot lesions in primary teeth: an in vitro study. J Indian Soc Pedod Prev Dent. 2017;35(3):229-37.

Manoharan V, Kumar RK, Sivanraj AK, Arumugam SB. Comparative evaluation of remineralization potential of casein phosphopeptide- amorphous calcium fluoride phosphate and Novamin on artificially demineralized human enamel: an in vitro study. Contemp Clin Dent. 2018;9(Suppl 1):58-63.

Shawky R, Khattab N, Yassa M. Evaluation of the remineralizing effect of theobromine and fluoride using scanning electron microscope. Egypt Dent J. 2021;67(1):119-26.

Taneja V, Nekkanti S, Gupta K, Hassija J. Remineralization potential of theobromine on artificial carious lesions. J Int Soc Prev Community Dent. 2019;9(6):576-83.

Amalina R, Soekanto SA, Gunawan H, Sahlan M. Analysis of CPP-ACP complex in combination with propolis to remineralize enamel. J Int Dent Med Res. 2017;10:814-9.

Mirkarimi M, Eskandarion S, Bargrizan M, Delazar A, Kharazifard MJ. Remineralization of artificial caries in primary teeth by grape seed extract: an in vitro study. J Dent Res Dent Clin Dent Prospects. 2013;7(4):206-10.

Hassan S, Hafez A, Elbaz MA. Remineralization potential of ginger and rosemary herbals versus sodium fluoride in treatment of white spot lesions: a randomized clinical trial. Egypt Dent J. 2021;67(2):1677-84.

Huang SB, Gao SS, Yu HY. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomed Mater. 2009;4(3):034104.

Itthagarun A, King NM, Rana R. Effects of child formula dentifrices on artificial caries like lesions using in vitro pH-cycling: preliminary results. Int Dent J. 2007;57(5):307-13.

Ozalp S, Tulunoglu O. SEM-EDX analysis of brushing abrasion of chitosan and propolis based toothpastes on sound and artificial carious primary enamel surfaces. Int J Paediatr Dent. 2014;24(5):349-57.

Nagi SM, Hassan SN, Abd El-Alim SHA, Elmissiry MM. Remineralization potential of grape seed extract hydrogels on bleached enamel compared to fluoride gel: an in vitro study. J Clin Exp Dent. 2019;11(5):e401-7.

Downloads

Published

2023-03-20

How to Cite

1.
Harman EB, Akleyin E. In-vitro investigation of remineralization efficacy of nanotechnological products and herbal-derived agents in primary teeth. J Clin Trials Exp Investig [Internet]. 2023 Mar. 20 [cited 2024 Apr. 25];2(1):45-52. Available from: https://jctei.com/index.php/jctei/article/view/46