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An evaluation of remineralised MIH using CPP-ACP and fluoride varnish: An in-situ and in-vitro study

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Abstract

Background

Molar incisor hypomineralization (MIH) affected teeth have enamel with altered mineral content like decreased calcium and phosphorus and increased carbon content leading to porous enamel and subsequent post-eruptive breakdown.

Aim

An in situ study was conducted to evaluate and compare the effects of a Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP)-based cream and fluoride varnish on the remineralization of MIH affected teeth.

Methods

Enamel slabs were prepared from MIH affected teeth that had been extracted for various reasons and inserted in appliances of 30 participants who were undergoing interceptive orthodontic therapy. They were randomly divided into two groups using block randomization technique: Group A—daily single application of CPP-ACP cream (n = 15); Group B—professional application of fluoride varnishes every 3 months (n = 15). After 6 months of regular wear of the appliance, the enamel slabs were placed under Field Emission Scanning Microscope (FESEM) and Energy-Dispersive Spectroscopy (EDS) for evaluation of ultra structure and mineral content, respectively.

Results

A significant increase in calcium and phosphorus content, and a decrease in carbon content was observed within the 6 months period, suggesting remineralization in both the groups. On comparing the Ca:P and Ca:C ratios, a significant increase in the Ca:C ratio was evident in the two groups. No significant difference was seen in the Ca:P ratio in the CPP-ACP group at six months. The inter-group comparison did not reveal any significant difference between the two groups either at baseline or at 6 months post-intervention.

Conclusion

Remineralization can be achieved in MIH affected teeth with the use of remineralizing agents.

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Acknowledgements

We would like to thank all the study participants for their contribution. We also thank Mrs. Kusum, statistician, for her kind support and assistance in answering all our queries regarding the analysis of data.

Funding

The authors received no financial support for the research, authorship and/or publication of this article.

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Authors and Affiliations

  1. Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    A. Kumar, A. Goyal, K. Gauba, A. Kapur & S. K. Singh

  2. Punjab University, Chandigarh, India

    S. K. Mehta

Authors
  1. A. Kumar
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  2. A. Goyal
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  3. K. Gauba
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  4. A. Kapur
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  5. S. K. Singh
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  6. S. K. Mehta
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Contributions

AK contributed to acquisition and interpretation; AG contributed to conception and design, analysis and interpretation and critically revised the manuscript; KG contributed to design, interpretation and critically revised the manuscript; AK contributed to interpretation and design and critically revised the manuscript; SKM contributed to design and analysis and critically revised the manuscript; SKS contributed to acquisition and analysis, drafted and critically revised the manuscript. All the authors gave their final approval and agreed to be accountable for all aspects of the work.

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Correspondence to S. K. Singh.

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The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

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Kumar, A., Goyal, A., Gauba, K. et al. An evaluation of remineralised MIH using CPP-ACP and fluoride varnish: An in-situ and in-vitro study. Eur Arch Paediatr Dent 23, 79–87 (2022). https://doi.org/10.1007/s40368-021-00630-5

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  • DOI: https://doi.org/10.1007/s40368-021-00630-5

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