Masking White-Spot-Lesions Color Using Resin-Infiltration, Self-Assembling Peptide, CPP-ACPF.

Objectives: This study aimed to compare three treatments; Resin-Infiltrate (Icon^®), Self-Assembling-Peptide (Curodont^TM Repair-Fluoride-Plus), and CPP-ACPF technology (MI Paste-One^®), for their ability to improve light reflectivity and mask the color of white spot lesions (WSLs) using spectrophotometric analysis.
Methods: 3x4mm treatment-windows were created by polishing the cervical 1/3 of the facial surface of 45 extracted human anterior and premolars. To induce artificial WSLs, treatment-windows were exposed to Quiroz-demineralization-solution for 72 hours. Specimens randomly allocated to 3 treatment-groups: ICON, Curodont, and MI (n=15). Treatments applied following manufacturers’ instructions. Groups underwent a pH-cycle challenge (4-hours demineralization, 20-remineralization) for 27 days. MI received phosphoric-acid etching twice and was applied daily. Spectrophotometer (VITA Easy Shade Compact) used to quantitatively measure enamel-lightness values (L*) of each sample at 4-time points; baseline (T0), after WSL creation (T1), immediately post-treatment (T2), and post pH-cycle (T3). Lightness-change (ΔL*) was analyzed using Tukey’s test.
Results: Within each group, repeated-measure-ANOVA showed statistically significant decrease in L* from T0 to T1, along with a chalky-white visual-appearance of the specimens, meeting the pre-defined criteria for successful WSL creation. Using Tukey’s test for between-groups comparison demonstrated that immediate application (T2) of Icon resulted in the lowest ΔL values (T1-T2), significantly differing from Curodont and MI Paste. After pH challenge, Icon and Curodont experienced significant drop in L* mean-value compared to T2. MI exhibited the least ΔL values at T3, while Curodont experienced a significant drop.
Conclusions: Within the study limitations, Curodont Repair-Fluoride-Plus, MI paste-One, and Icon treatments could not restore enamel lightness and translucency following the pH cycle. Icon provided significant improvement in lightness immediately after treatment; however, failed to maintain the improved L values following the pH challenge. Curodont did not induce significant change in L values after treatment and was significantly impacted by the pH challenge.