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. 2022 Mar 21;23(1):10.
doi: 10.1186/s40510-022-00404-9.

Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: an in-vitro study

Neven S Aref  1   2 , Maha Kh Alrasheed  3
Affiliations

Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: an in-vitro study

Neven S Aref et al. Prog Orthod. .

Abstract

Background: White spot lesion (WSL) is the most common consequence during and after orthodontic treatment. This study was conducted to investigate the ability of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) coupled with universal adhesive resin to treat white spot lesions.

Material and methods: Forty-five extracted premolars were sectioned to create 90 specimens. Seventy-five specimens were demineralized to generate artificially created WSLs. Different strategies have been applied for the management of the artificially created WSLs. Six experimental groups were employed: Group I: sound enamel (control), Group II: demineralized enamel (artificially-created WSLs), Group III: ICON resin-treated WSLs, Group IV: CPP-ACP-treated WSLs, Group V: universal adhesive resin-treated WSLs, and Group VI: CPP-ACP followed by universal adhesive resin-treated WSLs. Assessment of color stability using a spectrophotometer, surface microhardness using a Vickers tester, and surface roughness using a profilometer was done. The surface topography of representative specimens from each experimental group was inspected using a scanning electron microscope. Collected data were analyzed using one-way ANOVA followed by Tukey's post hoc test at p ≤ 0.05.

Results: White spot lesions treated with CPP-ACP and subsequently coated with universal adhesive resin (Group VI) exhibited a significantly lower ΔE than both CPP-ACP (Group IV) and universal adhesive resin-treated (Group V) groups (p ≤ 0.05), but it was not significantly different from the ICON resin-treated group (Group III). For surface microhardness, WSLs treated with CPP-ACP and consequently coated with universal adhesive resin (Group VI) recorded the highest mean that was significantly different from both ICON resin (Group III) and universal adhesive resin-treated (Group V) groups (p ≤ 0.05). All the tested strategies (ICON resin, CPP-ACP, universal adhesive resin, and CPP-ACP followed by universal adhesive resin) significantly lowered the surface roughness of the WSLs (p ≤ 0.05), while no significant difference was detected among them.

Conclusions: Combining a considerable caries remineralizing program using CPP-ACP with subsequent universal adhesive resin infiltration could be a promising approach to manage WSLs efficiently through increasing surface microhardness and restoring esthetic while developing a smoother surface.

Keywords: CPP-ACP; Enamel demineralization; Resin infiltration; Universal adhesive resin; White spot lesion.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Consort flow diagram
Fig. 2
Fig. 2
Color difference results of the investigated groups
Fig. 3
Fig. 3
Surface microhardness results of the investigated groups
Fig. 4
Fig. 4
Surface roughness results of the investigated groups
Fig. 5
Fig. 5
Scanning electron micrographs (× 2000 magnification) of the different experimental groups; a Sound enamel, b Artificially-created white spot lesion (demineralized enamel), c ICON resin-treated white spot lesion, d CPP-ACP-treated white spot lesion, e Universal adhesive resin-treated white spot lesion, f CPP-ACP with subsequent universal adhesive resin-treated white spot lesion
See this image and copyright information in PMC

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