Effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride on the microhardness of enamel treated with a bleaching agent: ex vivo

Yıl 2017, Cilt: 34 Sayı: 2, 61 - 66, 15.03.2017

Mügem Aslı Gürel Ekici , Fehime Alkan Hacer Deniz Arısu , Bağdagül Helvacıoğlu Kıvanç

https://doi.org/10.17214/gaziaot.267232

Öz

Objective: The
aim of this study was to compare the effects of casein phosphopeptide-amorphous
calcium phosphate (CPP-ACP) and 1.23% acidulated phosphate fluoride (APF; pH
3.5) on the microhardness of enamel treated with a bleaching agent.

Materials and Method: Enamel
slices (n=32; 2×4 mm) were obtained from 8 mandibular permanent molar teeth.
Specimens were embedded into acrylic resin blocks with the enamel surfaces
facing upwards. Vickers microhardness (VHN) values of the specimens were
recorded at baseline. The specimens were randomly divided into 4 experimental
groups, and the experimental designation was as follows: Group 1: no treatment
(control), Group 2: 35% hydrogen peroxide (HP), Group 3: HP + CPP-ACP, Group 4:
HP + APF application. After treatments, VHN values were measured and recorded
again. Specimens were stored in artificial saliva at 37 °C for 1 week. After 1
week second application was done and VHN of the specimens was registered once
more. Data were statistically analyzed with ANOVA and Tukey post hoc tests. Values obtained at
baseline, and first and second applications were compared using paired samples
t-test (α=0.05).

Results: In inter-group
comparisons, no statistically significant difference in the enamel
microhardness values was found between the baseline, and first and second
applications (p>0.05). In intra-group comparisons, again, no statistically
significant difference in the enamel microhardness values was found between the
baseline, and first and second applications (p>0.05).

Conclusion:
According to the limitations of this study it
can be concluded that neither the HP application nor the CPP-ACP or APF
application after HP had any significant effect on the enamel microhardness.

Anahtar Kelimeler

Casein phosphopeptide-amorphous calcium phosphate nanocomplex, dental enamel, hardness tests, hydrogen peroxide

Kazein fosfopeptit-amorf kalsiyum fosfat (CPP-ACP) ve floridin ağartma ajanı uygulanmış mine mikrosertliği üzerine etkisi: ex vivo

Öz

Amaç:
Bu çalışmanın amacı, kazein fosfopeptit-amorf kalsiyum fosfat (CPP-ACP)
ve %1.23 asitlenmiş fosfat florid (APF; pH 3.5) uygulamasının ağartma ajanı
uygulanmış mine mikrosertliği üzerine etkisinin değerlendirilmesi ve
karşılaştırılmasıdır.

Gereç
ve Yöntem: Sekiz alt daimi molar dişten toplam 32 adet mine
kesiti (2×4 mm)  elde edildi. Örnekler,
mine yüzeyleri açıkta kalacak şekilde akrilik rezin bloklara gömüldü.
Örneklerin başlangıç Vickers mikrosertlik (VHN) değerleri kaydedildi. Örnekler
rastgele 4 deney grubuna ayrıldı. Grup 1’de herhangi bir uygulama yapılmadı
(kontrol). Grup 2’de %35 hidrojen peroksit (HP), Grup 3’te %35 HP+CPP-ACP, Grup
4’te %35 HP+APF uygulandı. Uygulama sonrasında VHN değerleri ölçüldü ve
kaydedildi. Örnekler 1 hafta yapay tükürük içerisinde 37 °C’de inkübatörde bekletildi.
Bir hafta sonunda ikinci uygulamalar yapıldı ve örneklerin VHN değerleri tekrar
ölçüldü ve kaydedildi. Elde edilen veri ANOVA ve Tukey çoklu karşılaştırma
testiyle değerlendirildi. Başlangıç, birinci ve ikinci uygulamalar arasındaki
farklar bağımlı değişkenler t-testi kullanılarak karşılaştırıldı (α=0.05).

Bulgular: Gruplar
arası karşılaştırmalarda, başlangıç, diğer uygulamalar sonrası elde edilen mine
mikrosertlik değerleri arasında istatistiksel olarak anlamlı bir fark
gözlenmedi (p>0.05). Grup-içi karşılaştırmalarda, yine, başlangıç ve diğer
uygulamalar sonrasındaki mine mikrosertlik değerleri arasında istatistiksel
olarak anlamlı bir fark bulunmadı (p>0.05).

Sonuç: Bu çalışma koşullarında, %35 HP uygulaması sonrasında
veya %35 HP uygulaması ardından CPP-ACP ve APF uygulaması sonrasında mine yüzey
sertliğinin belirgin olarak etkilenmediği söylenebilir.

Anahtar Kelimeler

Diş minesi, hidrojen peroksid, kazein phosphopeptide amorf kalsiyum fosfat nanocomplex, sağlamlık testleri

Kaynakça

• Bizhang M, Seemann R, Duve G, Römhild G, Altenburger MJ, Jahn KR, et al. Demineralization effects of 2 bleaching procedures on enamel surfaces with and without post-treatment fluoride application. Oper Dent 2006;31:705-9.
• Watts A, Addy M. Tooth discolouration and staining: a review of the lirerature. Br Dent J 2001;190:309-16.
• Rajesh AG, Ranganath LM, Kumar KS, Rao BS. Surface morphological changes in human enamel following bleaching: an in vitro scanning electron microscopic study. J Contemp Dent Pract 2012;13:405-15.
• Murchison DF, Charlton DG, Moore BK. Carbamide peroxide bleaching: effects on enamel surface hardness and bonding. Oper Dent 1992;17:181-5.
• Burgmaier GM, Schulze IM, Attin T. Fluoride uptake and development of artificial erosions in bleached and fluoridated enamel in vitro. J Oral Rehabil 2002;29:799-804.
• Kamath U, Sheth H, Mullur D, Soubhagya M. The effect of Remin Pro on bleached enamel hardness: an in-vitro study. Indian J Dent Res 2013;24:690-3.
• Moi GP, Tenuta LM, Cury JA. Anticaries potential of a fluoride monthrinse evaluated in vitro by validated protocols. Braz Dent J 2008;19:91-6
• Groeneveld A, Van Eck AA, Backer Dirks O. Flouride in caries prevention: is the effect pre- or post-eruptive? J Dent Res 1990;69 Spec No:751-5; discussion 820-3.
• Marinho VC, Higgins JP, Logan S, Sheiham A. Topical fluoride (toothpastes, mounthrinses, gels or varnishes) for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003;4:CD002782.
• Jiang H, Bian Z, Tai BJ, Du MQ, Peng B. The effect of a bi-annual professional application of APF foam on dental caries increment in primary teeth: 24-month clinical trial. J Dent Res 2005;84:265-8.
• von der Fehr Fr, Larsen MJ, Bragelien J. Dental fluorosis in children on a fluoride program [abstract]. Caries Res 1989;23:455-6.
• Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res 1997;76:1587-95.
• Rose RK. Effects of an anticariogenic casein phosphopeptide on calcium diffusion in streptococcal model dental plaques. Arch Oral Biol 2000;45:569-75.
• Ardu S, Castioni NV, Benbachir N, Krejci I. Minimally invasive treatment of white spot enamel lesions. Quintessence Int 2007;38:633-6.
• Reynolds EC. Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review. Spec Care Dentist 1998;18:8-16.
• Lima DA, Aguiar FH, Liporoni PC, Munin E, Ambrosano GM, Lovadino JR. In vitro evaluation of the effectiveness of bleaching agents activated by different light sources. J Prosthodont 2009;18:249-54.
• DE Abreu DR, Sasaki RT, Amaral FL, Florio FM, Basting RT. Effect of home-use and in-office bleaching agents containing hydrogen peroxide associated with amorphous calcium phosphate on enamel microhardness and surface roughness. J Esthet Restor Dent 2011;23:158-68.
• Ahmadi Zenouz G, Ezoji F, Enderami SA, Khafri S. Effect of fluoride, casein phosphopeptide-amorphous calcium phosphate and casein phosphopeptide-amorphous calcium phosphate fluoride on enamel surface microhardness after microabrasion: An in vitro study. J Dent (Tehran) 2015;12:705-11.
• Calvo AF, Tabchoury CP, Del Bel Cury AA, Tenuta LM, da Silva WJ, Cury JA. Effect of acidulated phosphate fluoride gel application time on enamel demineralization of deciduous and permanent teeth. Caries Res 2012;46:31-7.
• Morjaria Y, Irwin WJ, Barnett PX, Chan RS, Conway BR. In vitro release of nicotine from chewing gum formulations. Dissolute Technol 2004;11:12-5.
• Shannon H, Spencer P, Gross K, Tira D. Characterization of enamel exposed to 10% carbamide peroxide bleaching agents. Quintessence Int 1993;24:39-44.
• Bayrak S, Tunc ES, Sonmez IS, Egilmez T, Ozmen B. Effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on enamel microhardness after bleaching. Am J Dent 2009;22:393-6.
• Feagin F, Koulourides T, Pigman W. The characterization of enamel surface demineralization, remineralization, and associated hardness changes in human and bovine material. Arch Oral Biol 1969;14:1407-17.
• Luk K, Tam L, Hubert M. Effect of light energy on peroxide tooth bleaching. J Am Dent Assoc 2004;135:194-201.
• Attin T, Schmidlin PR, Wegehaupt F, Wiegand A. Influence of study design on the impact of bleaching agents on dental enamel microhardness: a review. Dent Mater 2009;25:143-57.
• Buskes JA, Christoffersen J, Arends J. Lesion formation and lesion remineralization in enamel under constant composition conditions. A new technique with applications. Caries Res 1985;19:490-6.
• Meyer-Lueckel H, Umland N, Hopfenmuller W, Kielbassa AM. Effect of mucin alone and in combination with various dentifrices on in vitro remineralization. Caries Res 2004;38:478-83.
• Ten Cate JM. In vitro studies on the effects of fluoride on de- and remineralization. J Dent Res 1990;69 Spec No:614-9; discussion 634-6.
• White DJ, Featherstone JD. A longitudinal microhardness analysis of fluoride dentifrice effects on lesion progression in vitro. Caries Res 1987;21:502-12.
• Yamaguchi K, Miyazaki M, Takamizawa T, Inage H, Moore BK. Effect of CPP-ACP paste on mechanical properties of bovine enamel as determined by an ultrasonic device. J Dent 2006;34:230-6.
• Yesilyurt C, Sezer U, Ayar MK, Alp CK, Tasdemir T. The effect of a new calcium-based agent, Pro-Argin, on the microhardness of bleached enamel surface. Aust Dent J. 2013;58:207-12.
• Wegehaupt FJ, Tauböck TT, Stillhard A, Schmidlin PR, Attin T. Influence of extra- and intra-oral application of CPP-ACP and fluoride on re-hardening of eroded enamel. Acta Odontol Scand 2012;70:177-83.
• da Costa JB, Mazur RF. Effects of new formulas of bleaching gel and fluoride application on enamel microhardness: an in vitro study. Oper Dent 2007;32:589-94.
• Pai D, Bhat SS, Taranath A, Sargod S, Pai VM. Use of laser fluorescence and scanning electron microscope to evaluate remineralization of incipient enamel lesions remineralized by topical application of casein phospho peptide amorphous calcium phosphate (CPP-aCP) containing cream. J Clin Pediatr Dent 2008;32:201-6.
• Jayarayan J, Janardhanam P, Jayakumar P; Deepika. Efficacy of CPP-ACP and CPP-ACPF on enamel remineralization - an in vitro study using scanning electron microscope and DIAGNOdent. Indian J Dent Res 2011;22:77-82.
• Rahiotis C, Vougiouklakis G. Effect of a CPP-ACP agent on the demineralization and remineralization of dentine in vitro. J Dent 2007;35:695-8.
• Çetin B, Avşar A, Ulusoy AT. Kazein içerikli besinler ve dental ürünler. J Dent Fac Atatürk Uni 2011;4:24-31.
• Civelek A, Özel E, Çıldır Kavaloğlu Ş. Diş hekimliğinde topical florür uygulamaları. Ondokuz Mayıs Univ Diş Hekim Fak Derg 2004;5:103-9.
• Hayacibara MF, Paes Leme AF, Lima YB, Gonçalves NC, Queiroz CS, Gomes MJ, et al. Alkali-soluble fluoride deposition on enamel after professional application of topical fluoride in vitro. J Appl Oral Sci 2004;12:18-21.