Effects of Nanohydroxyapatite and Fluoride varnish on the Microhardness of the Artificially Induced Enamel Lesion: An In-Vitro Study
DOI:
https://doi.org/10.32828/mdj.v21i2.1159Keywords:
Key word, Nanohydroxyapatite, Microhardness, White spot lesion, Minimum invasive dentistry, Fluoride varnishAbstract
Study objective: To evaluate the ability of nanohydroxyapatite and fluoride varnish to remineralize an artificially induced enamel lesions. Methods: Fifty-four extracted premolar teeth were randomly allocated into three main groups (n=18) that are nanohydroxyapatite (n‑HA), fluoride varnish (FL) and untreated groups (C). The groups were further classified into three subgroups (n=6) based on the storage time in artificial saliva (1 week, 2 weeks, 4 weeks). All teeth subjected to pH cycling procedure for induction of white spot lesion. The nHA group was treated by immersing the samples in 10% n-HA solution for three minutes before storing them in artificial saliva. This procedure was repeated daily. Second group treated with fluoride varnish and third group left untreated. Microhardness was measured after 1 week, 2 week, 4 week from first time of application of treatment agents. Results: Statistical analysis of mean microhardness values demonstrated a significant difference in microhardness values according to different storage times only for the nanohydroxyapatite group while there was no significant differences in microhardness mean values for fluoride varnish and untreated group. Conclusion: 10% nanohydroxyapatite suspension more effective in remineralizing of WSLs as compare to fluoride varnish.
References
1. Marinelli, G., Inchingolo, A.D., Inchingolo, A.M., Malcangi, G., Limongelli, L., Montenegro, V., Coloccia, G., Laudadio, C., Patano, A., Inchingolo, F. and Bordea, I.R. White spot lesions in orthodontics: prevention and treatment. A descriptive review. Journal of biological regulators and homeostatic agents. 2021; 35(2 Suppl. 1): pp.227-240.
2. Haberal, Merve. WHITE SPOT LESIONS: DIAGNOSIS AND TREATMENT METHODS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2024.26(1): pp. 109-16.
3. Cosma, L.L., Şuhani, R.D., Mesaroş, A. and Badea, M.E. Current treatment modalities of orthodontically induced white spot lesions and their outcome–a literature review. Medicine and pharmacy reports. 2019; 92(1): p.25.
4. Chokshi, K., Chokshi, A., Konde, S., Shetty, S.R., Chandra, K.N., Jana, S., Mhambrey, S. and Thakur, S., "An in vitro comparative evaluation of three remineralizing agents using confocal microscopy." Journal of clinical and diagnostic research: JCDR. 2016; 10 (6): p ZC39.
5. Reynolds, E.C: Calcium Phosphate-Based Remineralization Systems: Scientific Evidence? Australian Dental Journal.2008; 53: 268–273.
6. Krishnan V, Bhatia A, and Varma H: Development, characterization and comparison of two strontium doped nano hydroxyapatite molecules for enamel repair/regeneration. Dental Material. 2016; 32:646–659.
7. Lei X, Gao J, Xing F, Zhang Y, Ma Y, Zhang G: Comparative evaluation of the physicochemical properties of nano-hydroxyapatite/collagen and natural bone ceramic/collagen scaffolds and their osteogenesis-promoting effect on MC3T3 E1 cells. Regen Biomater. 2019; 6:361–371.
8. Zakizade, M., Davoudi, A., Akhavan, A. and Shirban, F. Effect of resin infiltration technique on improving surface hardness of enamel lesions: A systematic review and meta-analysis. Journal of Evidence Based Dental Practice. 2020; 20(2): p.101405.
9. Barbakow, F., Sener, B., & Lutz, F. Dissolution of phosphorus from human enamel pretreated in vitro using SnF2 stabilized with amine fluoride. Clinical preventive dentistry. 1987; 9(5): 3–6.
10. Al-Sayyab, M., The potential effect of combined CO2 laser and fluoride on acid resistance of human dental enamel and root surfaces. An invitro study. 2000, University of Baghdad.
11. Featherstone J., Oreilly MM., Shariati M. and Bruder S: Enhancement of remineralization in vitro and in vivo In: Leach S.A. Ed. factor relating to demineralization and remineralization of the teeth. Oxford.1986: 23-34.
12. Hashim, Afrah Radhy, and Nidhal Sahib Mansoor. Effect of Different Surface Treatments on Surface Roughness and Vickers Micro-Hardness of Feldspathic Porcelain: An In Vitro Study. Mustansiria Dental Journal. 2024; 17(1): pp. 36–50.
13. HUANG SB. GAO SS. & YU HY. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomed Mater. 2009; 4:034104.
14. Gürbüz, Taskin. Evaluation of The Effects of Different Remineralization agents on Initial Enamel Lesions by Scanning Electron Microscope and Energy-Distributed X-ray Analysis. Authorea Preprints. 2021.
15. Kooshki, Fahimeh, Sahar Pajoohan, and Sanaz Kamareh. "Effects of treatment with three types of varnish remineralizing agents on the microhardness of demineralized enamel surface." Journal of clinical and experimental dentistry. 2019; 11(7): e630–e635.
16. Al Qaysi, Haitham T., Thekra I. Hamad, and Thair L. Al Zubaidy. "Analysis of the surface hardness of niobium carbide coatings deposited on commercially pure titanium and Ti-6Al-7Nb alloy implant materials using the glow discharge plasma technique. Humanities, social and applied sciences Misan Journal of Academic Studies. 2023; 22(48): 264-269.
17. Kashmoola, Mayada, and Aisha A. Qasim. "The Synergistic Effect of Aqueous Extracts of Iraqi Propolis and CPP-ACPF Paste on Enamel Microhardness after Demineralization Challenge." Al-Rafidain Dental Journal. 2021; 21(2): 292-306.
18. Kidd, E. A. M., and Ole Fejerskov. "What constitutes dental caries? Histopathology of carious enamel and dentin related to the action of cariogenic biofilms." Journal of dental research. 2004; 83(1): 35-38.
19. Wakwak, M. A., Alaggana, N. A. A. A., & Morsy, A. S. J. T. D. J. Evaluation of surface roughness and microhardness of enamel white spot lesions treated by resin infiltration technique (icons): An: In-vitro: study. Tanta dental journal. 2021; 18(3):88-91.
20. Amaechi, B.T., Lemke, K.C., Saha, S., Luong, M.N. and Gelfond, J. Clinical efficacy of nanohydroxyapatite-containing toothpaste at relieving dentin hypersensitivity: An 8 weeks randomized control trial. BDJ open. 2021;7(1): p.23.
21. de Carvalho, F.G., Vieira, B.R., Santos, R.L.D., Carlo, H.L., Lopes, P.Q. and de Lima, B.A.S.G. In vitro effects of nano-hydroxyapatite paste on initial enamel carious lesions. Pediatric dentistry. 2014; 36(3): pp.85E-89E.
22. A AL Again, Nabil, Mustafa S Atta, and Abd Allah A Alhady. "The effect of caries infiltration technique (Icons) on surface roughness and microhardness of enamel white spot lesions." Al-Azhar Journal of Dental Science. 2018; 21(1): 79-86.
23. Chaudhary, A., Ingle, N.A., Kaur, N. and Gupta, R. Effect of fluoridated dentifrices on microhardness of enamel surface: invitro study. Journal of Advanced Oral Research. 2013; 4(1): pp.11-16
24. Esfahani, Kiana Salehzadeh, Romina Mazaheri, and Leila Pishevar. "Effects of treatment with various remineralizing agents on the microhardness of demineralized enamel surface." Journal of dental research, dental clinics, dental prospects. 2015; 9(4): 239–245.
25. Oliveira, Marcia Regina Cabral, et al. "Microhardness of bovine enamel after different fluoride application protocols." Dental Materials Journal. 2019; 38(1): 61-67.
26. Kamal D, Hassanein H, Elkassas D, Hamza H. Comparative evaluation of remineralizing efficacy of biomimetic self-assembling peptide on artificially induced enamel lesions: An: in vitro: study. Journal of conservative dentistry. 2018 Sep 1;21(5):536-41.
27. Torres, C.R.G., Rosa, P.C.F., Ferreira, N.S. and Borges, A. Effect of caries infiltration technique and fluoride therapy on microhardness of enamel carious lesions. Operative dentistry. 2012; 37(4): pp.363-369.
28. Aziznezhad, Mahdiye, et al. "Comparison of the effect of resin infiltrant, fluoride varnish, and nano-hydroxy apatite paste on surface hardness and streptococcus mutans adhesion to artificial enamel lesions." Electronic physician. 2017. 9(3): 3934–3942.
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