الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 155 |  |  |
| | | from | 155 | | |
Abstract
Over the last few decades, fluoride varnishes have been shown to play an important role in the non-invasive treatment of early enamel lesions. Recently, fluoride varnishes with casein phosphopeptide amorphous calcium phosphate have been approved for use as remineralizing agents. The manufacturers claim that they have the ability to release calcium and phosphate ions into saliva, enhancing the remineralization process. So, this study aimed to evaluate the effect of fluoride varnish with casein phosphopeptide amorphous calcium phosphate on the remineralization of teeth with early enamel lesions. A random sample of twenty-five children aged 12-16 years old were selected from Pedodontic and Orthodontic clinics, Faculty of Dentistry, Tanta University. The children have just finished their orthodontic treatment with fixed orthodontic appliances. Each child had at least two white spot lesions on the facial surface of the maxillary permanent incisors. The selected fifty permanent maxillary incisors were randomly allocated into two equal groups using a split-mouth technique. In group I, the selected teeth were treated with casein phosphopeptide amorphous calcium phosphate plus fluoride “MI varnish”. In group II, the selected teeth were treated with 5% sodium fluoride “Proshield varnish”. Approval from the Research Ethics Committee was obtained and informed consents from parents as well as assents from children were obtained. Standardized digital radiographs were taken at baseline. The selected teeth were isolated with a rubber dam and the labial tooth surface was gently cleaned and dried with an air syringe. A thin, uniform layer of the treatment varnish was applied on the labial tooth surface using a specified brush, according to the manufacturer’s instructions. The varnish application was repeated every three months for a total of four applications in both groups. Standardized digital radiographs were taken after 12 months for both groups. Digital radiographs were analyzed using Visual Basic Program based on the subtraction concept to measure the mineral changes of enamel. For the energy dispersive x-ray spectrometer (EDX) evaluation, twenty sound premolars extracted for orthodontic reasons were used. Two layers of acid-resistant nail varnish were used to paint the surfaces of the tooth leaving a window of 4 × 4 mm on the center of the facial surface of each tooth. Teeth were immersed in 40 ml of the first demineralizing solution for 72 hours at 37 °C in an incubator to create the artificial early enamel lesion. Each tooth was sectioned longitudinally in a labiolingual direction through the center of the window into two halves, each half was embedded horizontally in an acrylic mould. One half was treated with the remineralizing agent (MI varnish for group I and Proshield varnish for group II) and the other half was left untreated and served as a control. All specimens were exposed to the pH cycling model over a period of 30 days, including cycles of demineralization and remineralization daily. The specimens were dehydrated, mounted on copper stubs, and exposed to EDX to measure Calcium and phosphate content of the specimens. The results of the current study revealed a significantly higher remineralization potential of casein phosphopeptide amorphous calcium phosphate plus fluoride “MI varnish” than 5% sodium fluoride “Proshield varnish”. Moreover, the energy dispersive x-ray spectrometer (EDX) evaluation revealed that casein phosphopeptide amorphous calcium phosphate plus fluoride “MI varnish” showed a significantly higher Ca deposition than 5% sodium fluoride “Proshield varnish”. Based on the findings of the present study, the following conclusions can be obtained: 1. Both casein phosphopeptide amorphous calcium phosphate plus fluoride “MI varnish” and 5% sodium fluoride “Proshield varnish” are effective in the remineralization of early enamel lesions. 2. Casein phosphopeptide amorphous calcium phosphate plus fluoride “MI varnish” showed a significantly higher remineralization potential than 5% sodium fluoride “Proshield varnish”. 3. Casein phosphopeptide amorphous calcium phosphate plus fluoride “MI varnish” showed a significantly higher Ca deposition than 5% sodium fluoride “Proshield varnish”.