IADR Abstract Archives
CPP-ACP Effect on Acid-Etched Enamel: In Vitro SEM Study
Objectives: This in vitro study evaluated effects of Casein Phosphopeptide-Amorphous Calcium Phosphate without Fluoride (CPP-ACP) and with Fluoride (CPP-ACP-F) Pastes and Toothpaste (TP) on acid-etched enamel using scanning electron microscopy (SEM).
Methods: 10 human extracted teeth with caries-free enamel were divided into 5 portions. Each portion underwent different treatment: 1) No Treatment Control (deionized-distilled water rinse [DDWR]); 2) Acid-Etching (37.5% phosphoric acid gel for 15s [Kerr Dental], followed by DDWR); 3) CPP-ACP (MI Paste, GC America); 4) CPP-ACP-F (MI Paste Plus, GC America); 5) CPP-ACP-FTP (MI Paste One, GC America). CPP-ACP groups were treated for 120s. followed by DDWR. Specimens were examined with SEM.
Results: No Treatment Control Group had intact enamel surfaces with occasional enamel prism ends. Acid-Etch Group showed enamel surfaces with typical etching patterns (type 1: prism core loss; type 2: prism periphery loss; type 3: mixture of type 1 and 2; type 4: surface porosities). CPP-ACP Treatment resulted in finely granular surface coatings with the vast majority of etched enamel prisms occluded, but with a certain degree of residual porosity, and partially exposed etched enamel prism. CPP-ACP-F Treatment created uniformly smooth surface coatings that completely masked the underlying acid-etched enamel surface. CPP-ACP-FTP Treatment produced surface coatings that were irregular in surface topography, but masked the underlying acid-etched enamel surface. Focal fractured areas of surface coatings with CPP-ACP-F and CPP-ACP-FTP treatment groups showed globular structures, morphologically resembling calcium fluoride.
Conclusions: Acid-etching of enamel is performed for placement of orthodontic brackets, sealants, and adhesive restorations. Acid-etching removes a superficial layer of enamel (up to 10um enamel loss) which is fluoride-rich. Adhesive materials may not cover all etched enamel. Remineralization of exposed etched enamel with calcium, phosphate and fluoride containing agents, and may replenish fluoride and promote remineralization of etched sound enamel and clinically undetectable hypomineralized enamel. The current in vitro SEM investigation illustrates ability of CPP-ACP agents with fluoride to create surface coatings that may act as reservoir for calcium, phosphate and fluoride.
Methods: 10 human extracted teeth with caries-free enamel were divided into 5 portions. Each portion underwent different treatment: 1) No Treatment Control (deionized-distilled water rinse [DDWR]); 2) Acid-Etching (37.5% phosphoric acid gel for 15s [Kerr Dental], followed by DDWR); 3) CPP-ACP (MI Paste, GC America); 4) CPP-ACP-F (MI Paste Plus, GC America); 5) CPP-ACP-FTP (MI Paste One, GC America). CPP-ACP groups were treated for 120s. followed by DDWR. Specimens were examined with SEM.
Results: No Treatment Control Group had intact enamel surfaces with occasional enamel prism ends. Acid-Etch Group showed enamel surfaces with typical etching patterns (type 1: prism core loss; type 2: prism periphery loss; type 3: mixture of type 1 and 2; type 4: surface porosities). CPP-ACP Treatment resulted in finely granular surface coatings with the vast majority of etched enamel prisms occluded, but with a certain degree of residual porosity, and partially exposed etched enamel prism. CPP-ACP-F Treatment created uniformly smooth surface coatings that completely masked the underlying acid-etched enamel surface. CPP-ACP-FTP Treatment produced surface coatings that were irregular in surface topography, but masked the underlying acid-etched enamel surface. Focal fractured areas of surface coatings with CPP-ACP-F and CPP-ACP-FTP treatment groups showed globular structures, morphologically resembling calcium fluoride.
Conclusions: Acid-etching of enamel is performed for placement of orthodontic brackets, sealants, and adhesive restorations. Acid-etching removes a superficial layer of enamel (up to 10um enamel loss) which is fluoride-rich. Adhesive materials may not cover all etched enamel. Remineralization of exposed etched enamel with calcium, phosphate and fluoride containing agents, and may replenish fluoride and promote remineralization of etched sound enamel and clinically undetectable hypomineralized enamel. The current in vitro SEM investigation illustrates ability of CPP-ACP agents with fluoride to create surface coatings that may act as reservoir for calcium, phosphate and fluoride.