Research Article
Volume 19 Issue 2 - 2020
Effect of Remineralizing Agents on Enamel Surface Roughness of Primary Teeth: An In-Vitro Study
Fouad Salama1*, Faika Abdelmegid2, Mohammed Al-Sharhan3, Faisal Al-Mutairi3 and Abdulrahman Al-Nasrallah3
1Professor, Pediatric Dentistry, School of Dentistry, University of Detroit Mercy, USA
2Former Professor, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
3Former Dental Interns, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
*Corresponding Author: Fouad Salama, Professor, Pediatric Dentistry, School of Dentistry, University of Detroit Mercy, USA.
Received: December 26, 2019; Published: January 09, 2020


Statement of Problem: Different new tooth remineralization agent for caries control to enhance the remineralization process and improve the mechanical properties of the demineralized substrate. Studying the influence of remineralizing agents on roughness of sound and demineralized enamel of primary teeth of critical importance in clinical dentistry.

Purpose: The objective of this in vitro study was to compare the effect of three remineralizing agents [casein phosphopeptide-amorphous calcium phosphate (CPP-ACP - MI Paste), casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF - MI Paste Plus), and hydroxyapatite (Remin Pro) on surface roughness of sound and demineralized enamel of primary teeth in vitro.

Materials and Methods: Sound and demineralized enamel were divided into 8/groups according to the remineralizing agents and control. The initial readings of surface roughness at baseline (T1) and after application of the three remineralizing agents for 30 minutes and seven and a half hours (T2 and T3) were recorded. The surface roughness {Sa = Arithmetic mean height}, {Sp = Maximum peak height}, and {Sv = Maximum valley depth} of the enamel specimens were analyzed.

Results: Sa for sound enamel after 8 hours application to Remin Pro was statistically significantly different from control, MI Paste, and MI Paste Plus. While for demineralized enamel after application of MI Paste was statistically significantly different from control while MI Paste Plus was statistically significantly different from Remin Pro and MI Paste. The lowest Sa at T3 was recorded for sound enamel after application of MI Paste.

Conclusion: There was significant difference of Sa for the sound and demineralized enamel of primary teeth at each tested time (T1, T2, and T3) after application of the remineralizing agents and artificial saliva.

Keywords: Surface Roughness; Remineralizing Agents; Enamel; Primary Teeth


  1. Patil N., et al. “Comparative evaluation of remineralizing potential of three agents on artificially demineralized human enamel: An in vitro study”. Journal of Conservative Dentistry 16.2 (2013): 116-120. 
  2. Heshmat H., et al. “The effect of Remin Pro and MI paste plus on bleached enamel surface roughness”. Journal of Dentistry Tehran 11.2 (2014): 131-136. 
  3. Zhou C., et al. “Casein phosphopeptide-amorphous calcium phosphate remineralization of primary teeth early enamel lesions”. Journal of Dentistry 42.1 (2014): 21-29.
  4. De Carvalho FG., et al. “In vitro effects of nano-hydroxyapatite paste on initial enamel carious lesions”. Pediatric Dentistry 36.3 (2014): 85-89.
  5. Gangrade A., et al. “In vitro evaluation of remineralization efficacy of different calcium- and fluoride-based delivery systems on artificially demineralized enamel surface”. Journal of Conservative Dentistry 19.4 (2016): 328-331.
  6. Justino LM., et al. “In situ and in vitro effects of bleaching with carbamide peroxide on human enamel”. Operative Dentistry 29.2 (2004): 219-225.
  7. Field J., et al. “Quantifying and qualifying surface changes on dental hard tissues in vitro”. Journal of Dentistry 38.3 (2010): 182-190.
  8. Abreu LG., et al. “Comparative study of the effect of acid etching on enamel surface roughness between pumiced and non-pumiced teeth”. Journal of International Oral Health 7.9 (2015): 1-6.
  9. Zafar MS and Ahmed N. “The effects of acid etching time on surface mechanical properties of dental hard tissues”. Dental Materials Journal 34.3 (2015): 315-320. 
  10. Penumatsa NV., et al. “Evaluation of remineralization capacity of casein phosphopeptide-amorphous calcium phosphate on the carbamide peroxide treated enamel”. Journal of Pharmacy and Bioallied Sciences 7.2 (2015): S583-586. 
  11. Mathias J., et al. “A comparison of surface roughness after micro abrasion of enamel with and without using CPP-ACP: An in vitro study”. Journal of Conservative Dentistry 12.1 (2009): 22-25. 
  12. Yesilyurt C., et al. “The effect of a new calcium-based agent, Pro-Argin, on the microhardness of bleached enamel surface”. Australian Dental Journal 58.2 (2013): 207-212.
  13. Janiszewska-Olszowska J., et al. “Effect of orthodontic debonding and residual adhesive removal on 3D enamel microroughness”. Peer Journal 4 (2016): e2558.
  14. Karan S and Toroglu MS. “Porcelain refinishing with two different polishing systems after orthodontic debonding”. The Angle Orthodontist 78.5 (2008): 947-953.
  15. Tholt de Vasconcellos B., et al. “Surface roughness in ceramics with different finishing techniques using atomic force microscope and profilometer”. Operative Dentistry 31.4 (2006): 44244-44249.
  16. Baumgartner S., et al. “An in vitro study on the effect of an oscillating stripping method on enamel roughness. Progress in Orthodontics 16 (2015): 1. 
  17. Elsayad I., et al. “Combining casein phosphopeptide-amorphous calcium phosphate with fluoride: Synergistic remineralization potential of artificially demineralized enamel or not?”. Journal of Biomedical Optics 14.4 (2009): 044039. 
  18. Hamba H., et al. “Effects of CPPACP with sodium fluoride on inhibition of bovine enamel demineralization: a quantitative assessment using microcomputed tomography”. Journal of Dentistry 39.6 (2011): 405-413.
  19. Borges BC., et al. “Efficacy of a novel at-home bleaching technique with carbamide peroxides modified by CPP-ACP and its effect on the microhardness of bleached enamel”. Operative Dentistry 36.5 (2011): 521-528.
  20. Klarić E., et al. “Surface changes of enamel and dentin after two different bleaching procedures”. Acta Clinica Croatica 52.4 (2013): 419-429.
  21. Akhoundi M., et al. “The effect of Remin Pro and MI Paste Plus on bleached enamel surface roughness”. Journal of Dentistry Tehran 11.2 (2014): 216-224.
  22. Reham M., et al. “Changes in surface roughness of bleached enamel by using different remineralizing agents”. Tanta Dental Journal 13.4 (2016): 179-186.
  23. Balan A., et al. “Comparative study regarding the effect of remineralizing products on primary teeth dissolution induced by acidic drinks”. Revista de Chime 66 (2015): 562-564.
  24. Bolan M., et al. “Erosive effects of acidic center-filled chewing gum on primary and permanent enamel”. Journal of Indian Society of Pedodontics and Preventive Dentistry 26.4 (2008): 149-152.
  25. Badr SBY and Ibrahim MA. “Protective effect of three different fluoride pretreatments on artificially induced dental erosion in primary and permanent teeth”. Journal of American Science 6.11 (2010): 442-451.
  26. Shellis RP. “Relationship between human enamel structure and the formation of caries-like lesions in vitro”. Archives of Oral Biology 29.12 (1984): 975-981.
  27. Wang LJ., et al. “Enamel demineralization in primary and permanent teeth”. Journal of Dental Research 85.4 (2006): 359-363.
  28. Sabel N., et al. “Demineralization of enamel in primary second molars related to properties of the enamel”. The Scientific World Journal (2012): 587254.
  29. Wong FSL., et al. “X-ray microtomographic study of mineral concentration distribution in deciduous enamel”. Archives of Oral Biology 49.11 (2004): 937-944.
  30. Araujo Fde O., et al. “In situ study of inoffice bleaching procedures using light sources on human enamel microhardness”. Operative Dentistry 35.2 (2010): 139-146.
  31. Sasaki RT., et al. “Effect of 7.5% hydrogen peroxide containing remineralizing agents on hardness, color change, roughness and micromorphology of human enamel”. American Journal of Dentistry 28.5 (2015): 261-267.
  32. Ebrahimi M., et al. “The effects of three remineralizing agents on regression of white spot lesions in children: A two-week, single-blind, randomized clinical trial”. Journal of Clinical and Experimental Dentistry 9.5 (2017): e641-e648. 
  33. Delbem AC., et al. “Effect of fluoridated varnish and silver diamine fluoride solution on enamel demineralization: pH-cycling study”. Journal of Applied Oral Science 14.2 (2006): 88-92.
  34. Lata S., et al. “Remineralization potential of fluoride and amorphous calcium phosphatecasein phosphopeptide on enamel lesions: an in vitro comparative evaluation”. Journal of Conservative Dentistry13.1 (2010): 42-46.
  35. Kukiattrakoon B., et al. “Effect of acidic agents on surface roughness of dental ceramics”. Journal of Dental Research 8.1 (2011): 6-15.
Citation: Fouad Salama., et al. “Effect of Remineralizing Agents on Enamel Surface Roughness of Primary Teeth: An In-Vitro Study”. EC Dental Science 19.2 (2020): 01-12.

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