Remineralisation of Enamel Subsurface Lesions in vitro by Tooth Mousse™

Objectives: To investigate the potential of dilutions of a commercially available dental crème containing casein phosphopeptide – amorphous calcium phosphate (CPP-ACP), Tooth Mousse^TM (TM) (10% w/v CPP-ACP) (GC Corp, Japan), with deionised water (DDW) or unstimulated human saliva (HS), to remineralise enamel subsurface lesions (ESL) in vitro. Methods: Fifteen enamel specimens were sectioned from buccal or lingual surfaces of extracted sound third molars and ESL windows were created using the Carbopol method. Unstimulated human saliva was collected from one donor, pooled and stored at 4^oC. Specimens were randomly assigned to 3 groups: TM diluted w/w to 25% with DDW (TM25%), TM diluted to 50% w/w with saliva (TM/HS), and saliva (HS). Specimens were immersed in the solutions at 37^oC for 28 days; solutions were changed daily. The ESL images were captured using a Quantitative Light-induced Fluorescence (QLF) system under controlled conditions at baseline and at endpoint. The change in ESL fluorescence (ΔF) was determined using proprietary software (Inspektor, Amsterdam, The Netherlands); proportional percentage changes in ΔF were calculated according to the formula %F= (ΔF_baseline–ΔF_endpoint) / ΔF_baseline and analysed (ANOVA, Tukey's post-hoc, alpha=0.05). Results: Increased mineralisation of ESL was observed in all groups: TM25%: %F= 33.6±18.2%; TM/HS: %F= 51.4±11.6%; HS: %F= 22.4±10.4%. Significantly greater remineralisation occurred with TM/HS than HS (p=0.04). Conclusion: The mineralization of ESL increased following application of CPP-ACP and human saliva. TM/HS produced significantly greater remineralisation than HS alone. This study was supported by the Australian Dental Research Foundation and the Cooperative Research Centre for Oral Health Science, School of Dental Science, The University of Melbourne.