• The korean journal of orthodontics
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• v.43 no.1
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• pp.23-28
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• 2013

Objective: The purpose of this study was to evaluate the effect of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) on the shear bond strength (SBS) of brackets bonded to non-demineralized teeth with either phosphoric acid etching or self-etching primer. Methods: Sixty human premolars were randomly assigned to 1 of 4 treatment groups (n = 15 each): phosphoric acid etching (group 1); self-etching primer (group 2); CPP-ACP for 2 weeks + phosphoric acid etching (group 3), and CPP-ACP for 2 weeks + self-etching primer (group 4). After bonding of the maxillary premolar metal brackets, specimens were subjected to shear forces in a testing machine. Scanning electron microscopy was used to observe etching patterns on the enamel surfaces of all teeth. A 2-way analysis of variance was used to test for effects of CPP-ACP and etching system on SBS. Results: Significantly higher mean SBSs were observed in groups subjected to phosphoric acid etching (i.e., groups 1 and 3; p < 0.05). On the other hand, SBSs did not appear to be influenced by CPP-ACP (i.e., groups 3 and 4; p > 0.05). We observed a uniform and clear etched pattern on the enamel surface of the phosphoric acid etching groups. Conclusions: CPP-ACP does not significantly affect the SBS of orthodontic brackets bonded to non-demineralized teeth, regardless of which adhesive method is used to bond the brackets.

• Journal of Korean society of Dental Hygiene
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• v.10 no.3
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• pp.473-481
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• 2010

Objectives : To evaluate the effect of fluoride application on the color and microhardness of bleached enamel and compare it to that of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application. Methods : Twenty freshly extracted human adult molar were each sectioned into halves, the specimens divided and treated according to five experimental groups: Group 1, treatment with 10% carbamide peroxide (CP) bleaching agent; Group 2, treatment with 10% CP followed by a 1.23% fluoride gel application; Group 3, treatment with 10% CP followed by a 2.23% sodium fluoride varnish application; Group 4, treatment with 10% CP followed by a 0.11% sodium fluoride gel application; Group 5, treatment with 10% CP followed by a CPP-ACP gel application. All groups were treated 6 h per day for 14 days then immersed in distilled water for 2 weeks. Changes in enamel color were evaluated on Baseline and Day 14. Microhardness were evaluated on Baseline, Days 7 and 14. Statistical analysis was performed using one-way ANOVA and post-hoc Tukey tests. Results : All the bleached enamel specimens revealed increased whiteness and overall color value. Group 1 showed the lowest microhardness values than that of Groups 2, 3, 4 and 5. In all groups, the hardness of tooth after bleaching showed a significant decrease in the microhardness as compared with the one prior to tooth bleaching. The specimens treated with remineralizing agents showed relatively less reduction in enamel microhardness than control group. Conclusions : The addition of fluoride and CPP-ACP did not impede the whitening effect. The use of remineralizing agents during bleaching treatment can significantly enhance the microhardness of bleached enamel.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.45.1-45.11
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• 2018

Objectives: This study was conducted to evaluate fluoride release and the micro-shear bond strength of resin-modified glass ionomer cement (RMGIC) in casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-remineralized caries-affected dentin (CAD). Materials and Methods: Exposed dentin surfaces of 30 human third molar teeth were divided into 2 equal groups for evaluating fluoride release and the micro-shear bond strength of RMGIC to CAD. Each group was subdivided into 3 equal subgroups: 1) control (sound dentin); 2) artificially demineralized dentin (CAD); 3) CPP-ACP remineralized dentin (remineralized CAD). To measure fluoride release, 15 disc-shaped specimens of RMGIC (4 mm in diameter and 2 mm in thickness) were bonded on one flat surface of the dentin discs of each group. Fluoride release was tested using ion chromatography at different intervals; 24 hours, 3, 5, 7 days. RMGIC micro-cylinders were built on the flat dentin surface of the 15 discs, which were prepared according to the assigned group. Micro-shear bond strength was measured after 24 hours water storage. Data were analyzed using 1- and 2-way analysis of variance and the post hoc least significant difference test (${\alpha}=0.05$). Results: Fluoride detected in solutions (at all intervals) and the micro-shear bond strength of RMGIC bonded to CPP-ACP-remineralized dentin were significantly higher than those bonded to artificial CAD (p < 0.05). Conclusions: Demineralized CAD consumes more fluoride released from RMGIC into the solution for remineralization than CPP-ACP mineralized dentin does. CPP-ACP increases the micro-shear bond strength of RMGIC to CAD.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.4
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• pp.391-400
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• 2016

The purpose of this study was to evaluate the difference of remineralization effects of various anti-cariogenic toothpastes on artificial carious lesions in primary and permanent teeth using quantitative light-induced fluorescence-digital (QLF-D) system. Sound human primary (n = 48) and permanent teeth (n = 48) were randomly divided into following groups : control group (Group 1), fluoride toothpaste (Group 2), functionalized tricalcium phosphate (fTCP) + fluoride toothpaste (Group 3), and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) toothpaste (Group 4). Specimens were prepared by exposure in a demineralizing solution and then treated using the different toothpastes twice daily during 14 days. All specimens were analyzed with the QLF-D system. QLF data analysis indicated three different toothpastes showed significant remineralizing effects compared to Group 1 in both primary and permanent teeth. Also, the remineralizing effects in Group 3 and 4 were significantly higher than in Group 2. This study suggested that the toothpastes containing fTCP + fluoride and CPP-ACP have the significant anti-cariogenic effects on enamel demineralization in both primary and permanent teeth, and QLF-D is an useful device to assess the incipient carious lesion and remineralization effects of the anti-cariogenic materials quantitatively. Therefore, clinicians can consider the QLF-D system for the evaluation of demineralization and remineralization in primary and permanent teeth.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.9
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• pp.5602-5609
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• 2014

This study examined the remineralization effect of CPP-ACFP according to the etching time and the frequency of application. A CPP-ACFP paste was formed from a combination of CPP-ACP paste and fluorine. The remineralization effect of CPP-ACFP was measured according to the etching time and the frequency of applications of CPP-ACFP. The microhardness of 64 teeth was measured as the sound sample and observed by scanning electron microscopy. As a result, the effect on remineralization of the enamel increased with increasing etching time and frequency of application. Therefore, a CPP-ACP paste combination to fluorine in the tooth mineral CPP-ACFP paste fluoride application can be supplied with the material-advisable enamel remineralization.

• The korean journal of orthodontics
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• v.44 no.3
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• pp.113-118
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• 2014

Objective: The purpose of this in vitro study was to examine the effects of fluoridated, casein phosphopeptide-amorphous calcium phosphate complex (CPP-ACP)-containing, and functionalized ${\beta}$-tricalcium phosphate (fTCP)-containing toothpastes on remineralization of white spot lesions (WSLs) by using Quantitative light-induced fluorescence (QLF-D) Biluminator$^{TM}$ 2. Methods: Forty-eight premolars, extracted for orthodontic reasons from 12 patients, with artificially induced WSLs were randomly and equally assigned to four treatment groups: fluoride (1,000 ppm), CPP-ACP, fTCP (with sodium fluoride), and control (deionized water) groups. Specimens were treated twice daily for 2 weeks and stored in saliva solution (1:1 mixture of artificial and human stimulated saliva) otherwise. QLF-D Biluminator$^{TM}$ 2 was used to measure changes in fluorescence, indicating alterations in the mineral contents of the WSLs, immediately before and after the 2 weeks of treatment. Results: Fluorescence greatly increased in the fTCP and CPP-ACP groups compared with the fluoride and control groups, which did not show significant differences. Conclusions: fTCP- and CPP-ACP-containing toothpastes seem to be more effective in reducing WSLs than 1,000-ppm fluoride-containing toothpastes.

• The korean journal of orthodontics
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• v.42 no.1
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• pp.17-22
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• 2012

Objective: To study and compare the effects of different demineralization-inhibition methods on the shear bond strength (SBS) and fracture mode of an adhesive used to bond orthodontic brackets to demineralized enamel surfaces. Methods: Eighty freshly extracted, human maxillary premolars were divided into 4 equal groups and demineralized over the course of 21 days. Brackets were bonded to the demineralized enamel of teeth in Group 1. In Group 2, bonding was performed following resin infiltration ($ICON^{(R)}$, DMG, Hamburg, Germany). Before bonding, pre-treatment with acidulated phosphate fluoride (APF) or solutions containing casein phosphopeptide-amorphous calcium phosphate with 2% neutral sodium fluoride (CPP-ACP/wF) was performed in Groups 3 and 4, respectively. The SBS values of the brackets were measured and recorded following mechanical shearing of the bracket from the tooth surface. The adhesive remnant index (ARI) scores were determined aft er the brackets failed. Statistical comparisons were performed using one-way ANOVA, Tukey's post-tests, and G-tests. Results: Significant differences were found in some of the intergroup comparisons of the SBS values (F = 39.287, p < 0.001). No significant differences were found between the values for the APF-gel and control groups, whereas significantly higher SBS values were recorded for the resin-infiltrated and CPP-ACP/wF-treated groups. The ARI scores were also significantly different among the 4 groups (p < 0.001). Conclusions: Tooth surfaces exposed to resin infiltration and CPP-ACP/wF application showed higher debonding forces than the untreated, demineralized surfaces.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.1-12
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• 2010

The aim of this study was to evaluate the preventive effect of commercially available anticariogenic products, specifically, the tooth cream containing Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP), fluoride varnish and low-level fluoride mouthrinse on enamel erosion induced by carbonated beverage in a short period of time. Enamel specimens were treated as follows and were then kept in artificial saliva for 24 hours followed by further processing by alternately soaking them in Cola beverage and in distilled water for 1 minute each five times. Group 1: control group (no treatment) Group 2: tooth cream with CPP-ACP Group 3: fluoride varnish (1,000 ppm F) Group 4: low-level fluoride mouthrinse (227 ppm F) Group 5: fluoride varnish + tooth cream with CPP-ACP Group 6: low-level fluoride mouthrinse + tooth cream with CPP-ACP Microhardness and erosion depth were measured and the mineral loss of each specimen was evaluated by measuring the volumetric fluorescence change(${\Delta}Q$) against the stable fluorescent grid using quantitative light-induced fluorescence(QLF). The experiment lasted for 6 days repeated each day. The results were as follows: 1. The microhardness was increased as follows: Group $1{\leq}2{\leq}4$<6<$3{\fallingdotseq}5$. 2. The mean erosion depth was increased as follows: Group $5{\fallingdotseq}3$<6<$4{\fallingdotseq}2{\fallingdotseq}1$. 3. The ${\Delta}Q$ was increased as follows: Group $1{\fallingdotseq}2{\leq}4{\leq}6{\leq}3{\fallingdotseq}5$. The decrement of ${\Delta}Q$ was similar between group 1 and 2, group 4 and 6 and group 3 and 5. 4. The ${\Delta}Q$ showed positive correlation with microhardness (r=0.96, p<0.05), while it was negatively correlated to erosion depth (r=-0.96, p<0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.287-296
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• 2008

The purpose of this in vitro study was to compare the remineralization effect of commercially available anticariogenic products, exactly low level fluoride mouthrinse(500 ppm NaF), tooth cream with Casein phosphopeptide-amorphous calcium phosphate(CPP-ACP) and fluoride mouthrinse plus tooth cream on artificial caries lesion. Artificial caries lesion was induced at the buccal surface of permanent third molar and the specimens were then divided(16 specimens/group) into four group. Twice a day during 28 days specimens of each group were treated with a commercially anticariogenic product as follows and applied to the pH cycling system. Group 1: control group (No treatment) Group 2: Tooth $Mousse^{(R)}$ (GC Co. Japan) Group 3: $chikachika^{(R)}$ (Samil Co. Korea) Group 4: $chikachika^{(R)}$+Tooth Mousse$^{(R)}$ The long-term change of mineral loss(${\Delta}Q$) was evaluated by quantitative light-induced fluorescence (QLF) and the following results were obtained: 1. ${\Delta}Q$ of Group 1 was not noticed statistically significant during 28 days comparing that prior to treatment. There was a statistically significant increase in ${\Delta}Q$ of Group 2 and 3 since 14 days. So was in ${\Delta}Q$ of Group 4 since 7 days. 2. ${\Delta}Q$ was increased as follows: Group 1< Group 2, 3< Group 4. 3. Comparing with Group 1, Group 2 was a statistically significant increase since 7 days and Group 3 and 4 were since 3 days. Comparing Group 2 with 3, there was not noticed statistically significant during whole duration. Group 4 was significantly higher than Group 2 and 3 after 28 days. 4. All groups demonstrated a decrease in the rate of remineralization as time goes on.

• Journal of Korean Dental Hygiene Science
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• v.5 no.1
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• pp.29-38
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• 2022

Background: This study aimed to compare the remineralization effects of sodium caseinate and other substances on artificially demineralized enamel. Methods: We selected 25 healthy human premolars and molars and produced a total of 75 specimens by dividing them into five groups: control group, with distilled water; experimental group 1 (EG1), with 3% sodium caseinate; EG2, with 10% sodium caseinate; EG3, with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP); and EG4, with 0.05% NaF. Subsequently, the specimens were immersed in an artificial demineralization solution for 60 min. The demineralized specimens were then immersed in a remineralization solution for 7 days. Surface microhardness was measured using a microhardness tester, and remineralized lesions were observed under a scanning electron microscope (SEM). Regarding statistical analysis, the paired t-test and analysis of variance were performed using the SPSS program. Results: Although the surface hardness of the remineralized lesions increased significantly in all groups (p<0.05), the average increment did not differ significantly between the groups. The surface microhardness of CPP-ACP was the highest, followed by that of 0.05% NaF and 10% sodium caseinate. The remineralization effect of sodium caseinate was similar to that of 0.05% NaF. SEM confirmed that all groups treated with the remineralization solution were remineralized. Conclusions: Although the remineralization effect of sodium caseinate was slightly lower than that of CPP-ACP, it was similar to that of 0.05% NaF. Therefore, to enhance the remineralization effect of sodium caseinate, the appropriate concentration and application time should be determined.