• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.278-286
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• 2008

Many studies regarding Casein phosphopeptides-amorphous calcium phosphate(CPP-ACP) have demonstrated the remineralization ability on the demineralized enamel surface. A question is still remained that how deep can the calcium (Ca) and phosphorus (P) ions supplied by the CPP-ACP paste penetrate into the enamel subsurface. The aims of this study were to measure the penetrating depth of Ca and P ions in the demineralized human enamel in vitro, and were to determine the amount and depth of Ca and P ions according to the duration. The amount and depth of Ca and P ions were measured by microscopic observation with Field Emission Scanning Electron Microscopy (FE-SEM; LEO SUPRA 55, Carl Zeiss, Germany) and Energy Dispersive X-ray Spectrometer (EDS; GENESIS 2000, EDAX, USA: Linescan of Calcium and Phosphorus). Freshly extracted four human 1st premolars were obtained from the Dept. of Pediatric Dent., Kyung Hee Univ. Buccal surfaces of the 1st premolars were covered with nail varnish to form a window on the middle third of buccal surface. All of the teeth with enamel windows were immersed in a solution of 0.1 M lactic acid, Carbopol C907 (carboxypolymethylene BF Goodrich, Cleveland, OH, USA) at pH 4.8, and then incubated for 7 days. Each tooth crown was sawn in half through the midline of buccal window along the long axis of premolar. The four blocks of premolars were immersed in a 10-times diluted solution of CPP-ACP paste (Tooth Mousse, GC Corp., Tokyo, Japan) for 1, 2, 3 and 5 weeks while the rests were immersed in a placebo solution (distilled water) for the same duration. Each specimen was embedded in epoxy resin, and was sectioned perpendicular to the window, using a water-cooled diamond blade saw. The spectrum density indices of Ca and P were measured in the sound, de- and remineralized enamels by FE-SEM and EDS. The Student's t test was performed to compare the Spectrum Density Indices (SDI) of sound, re-and demineralized enamels, and to compare the differences among the durations. Followings are the conclusion : 1. The penetration depth of the remineralizing ions (Ca & P) of CPP-ACP paste is related to the depth of demineralized enamel (approximately $1050{\sim}1350{\mu}m$). It is revealed that the penetration depth of both ions reaches full thickness of decalcification and even slightly into the sound enamel. 2. The Ca & P levels of remineralized enamels in 1, 2 weeks were significantly higher than those of the sound enamels (p<0.05). 3. No statistically significant difference of Ca & P levels was found in relation with the increasing duration of remineralization (p>0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.38-45
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• 2009

The aim of this study was to examine efficacy of the commercially available 10% CPP-ACP cream (Tooth mousse, GC Co., Japan) and/or 0.05% NaF solution on the remineralization of artifical caries-like lesion in the bovine teeth enamel. Sixty bovine teeth were embedded in orthodontic resin and flattened. The enamel surface in 3 mm diameter was exposed with nail varnish. Specimens were stored in demineralizing solution and divided 5 groups; Group 1 (No treatment), 2 (0.05% NaF solution 1 min), 3 (Tooth mousse 3 min), 4 (After 0.05% NaF solution, Tooth mousse treatment), and 5 (After Tooth mousse treatment, soaking in 0.05% NaF solution during 1 min). After treatment by groups, all specimens was stored in artificial saliva for 30 min. After the process described as above was performed during 10 days without pH cycling, surface hardness (Vickers Hardness Number, VHN) was tested and analyzed by paired t-test and one-way ANOVA test with SPSS 14.0. In intragroup comparison between surface hardness of pre and post-treatment, group 3, 4, 5 showed statistically significant increase (P < 0.05). In intergroup comparison among surface hardness increase of all groups, difference of group 5 between pre and post-treatment ($15.80{\pm}12.21$) was the highest, and followed by group 4 ($14.27{\pm}11.73$), 3 ($4.05{\pm}5.18$), 2 ($1.15{\pm}6.83$), 1 ($0.78{\pm}6.21$). Tooth mousse can be a good alternative agent for the fluoride, and the combination use with fluoride might have the additional anticariogenic effect.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.4
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• pp.412-418
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• 2017

During orthodontic treatment, formation of white spot lesions (WSLs) around brackets has long been recognized as a potential risk. This study performed to investigate effect of preventing enamel demineralization and remineralization by application of fluoride-containing orthodontic primer. Fifty extracted bovine incisors teeth were randomly allocated to 3 groups: (I) Non-preparation specimens, (II) Application of Light Bond$^{TM}$ as fluoride containing orthodontic primer, (III) Application of Transbond$^{TM}$ XT Primer as traditional orthodontic primer without fluoride. Each group is demineralized under artificial carious solution. The demineralization pattern was evaluated using a Q-ray view, Vickers hardness test and polarized light microscope. The remained primer was calculated as 35 - 50%. The highest surface microhardness was shown on Light Bond$^{TM}$ surface. There were statistically significant differences in Vickers microhardness number between adjacent areas of Light Bond$^{TM}$ and non-prepared area. There was almost no demineralization of the enamel surface under the Light Bond$^{TM}$. At the adjacent site of Light Bond$^{TM}$, the shallow caries pattern and remineralization appearance were also observed. These results suggest that the use of fluoride-containing primers may be useful for bracket attachment to reduce enamel demineralization during orthodontic treatment.

• The Journal of the Korean dental association
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• v.56 no.8
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• pp.424-431
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• 2018

Silver diamine fluoride (SDF) is an alkaline topical solution and it derives from the conjunction of silver nitrate and fluoride. It reduces the growth of cariogenic bacteria, inhibits degradation of dentinal collagen, impedes demineralization and enhances remineralization. It is inexpensive due to the low cost of materials and its application to dental surface is very simple and requires relatively short chair time. Previous studies have shown that the dental caries prevention effect of SDF is superior or similar to topical fluoride application. The main disadvantage of SDF is its esthetic result, and it permanently blacken carious enamel and dentin. The use of SDF has not yet been approved in Korea, but it may be helpful to prevent and treat dental caries in patients with special health care needs and uncooperative young patients.

• Restorative Dentistry and Endodontics
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• v.32 no.6
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• pp.498-513
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• 2007

Since it was reported that incipient enamel caries can be recovered, previous studies have quantitatively evaluated that enamel artificial caries have been, remineralized with fluoride showing simultaneously the increase of width of surface layer and the decrease of width of the body of legion. There is, however, little report which showed that remineralization could occur without fluoride. In addition, the observations on the change of hydroxyapatite crystals also have been scarcely seen. In this study, enamel caries in intact premolars or molars was induced by using lactic acidulated buffering solutions over 2 days. Then decalcified specimens were remineralized by seven groups of solutions using different degree of saturation(0.212, 0.239, 0.301, 0.355) and different pH(5.0, 5.5, 6.0) over 10 days. A qualitative comparison to changes of hydroxyapatite crystals after fracturing teeth was made under SEM(scanning electron microscopy) and AFM(atomic force microscopy). The results were as follows: 1. The size of hydroxyapatite crystals in demineralized area was smaller than the normal ones. While the space among crystals was expanded, it was observed that crystals are arranged irregularly. 2. In remineralized enamel area, the enlarged crystals with various shape were observed when the crystals were fused and new small crystals in intercrystalline spaces were deposited. 3. Group 3 and 4 with higher degree of saturation at same pH showed the formation of large clusters by aggregation of small crystals from the surface layer to the lesion body than group 1 and 2 with relatively low degree of saturation at same pH did. Especially group 4 showed complete remineralization to the body of lesions. Group 5 and 6 with lower pH at similar degree of saturation showed remineralization to the body of lesions while group 7 didn't show it. Unlike in Group 3 and 4, Group 5 and 6 showed that each particle was densely distributed with clear appearance rather than crystals form clusters together.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.403-411
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• 2010

This study is about the treatment effect of fluoride varnish on white lesion. The changes in microhardness values and lesion sizes were compared and analyzed in relation to application interval, frequency, etc. Resin blocks were fabricated with the crown portion of permanent molars. Samples were classified into group I(1 week), group II(2 weeks) and group III(3 weeks) based on fluoride application intervals, each with 15 samples. Samples were soaked into a decalcifying solution for 15 days, and stored in artificial saliva at $37^{\circ}C$ thermostat. The changes in microhardness values and lesion sizes, before/after decalcification and after fluoride application, were evaluated. The following results were obtained. 1. Microhardness values in group II and III exhibited almost twice the increasing rate than group I. There were significant differences between group I and II, and group I and III (p<0.05), but none between group II and III (p>0.05). 2. Change in lesion sizes showed no significant differences between group I and II, III (p>0.05). In conclusion, fluoride varnish application results in both qualitative and quantitative improvements in white lesions. The satisfactory results can be obtained when varnish is applied at more than 2 weeks interval.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.44-50
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• 2016

The purpose of this study was to compare and evaluate the remineralization effect of three types of fluoride varnishes on demineralized enamel of primary teeth. 40 primary teeth were decalcified by soaking them in artificial acidic solution and stored at $37^{\circ}C$ for 7 days. Then 3 varnishes - Cavity shield$^{TM}$, V varnish$^{TM}$ and MI varnish$^{TM}$ were applied respectively one time a week, for 3 weeks on the demineralized enamel surface. For the first week, MI varnish$^{TM}$ showed the highest microhardness value, V varnish$^{TM}$ was in second position, and Cavity shield$^{TM}$ showed the lowest microhardness value. However, there was no significant difference among the three groups(p > 0.05). For the second week, V varnish$^{TM}$ showed the highest microhardness value, and MI varnish$^{TM}$ came next in second position noting no significant difference (p > 0.05). Cavity shield$^{TM}$ was significantly lower than the other groups (p < 0.05). For the third week, V varnish$^{TM}$ showed the highest microhardness value, noting a significant difference from the other groups (p < 0.05). MI varnish$^{TM}$ came next, while Cavity shield$^{TM}$ showed the lowest microhardness value. However, there was no significant difference between MI varnish$^{TM}$ and Cavity shield$^{TM}$ (p > 0.05). The increase in the microhardness of groups V varnish$^{TM}$ and MI varnish$^{TM}$ were higher than that of group Cavity shield$^{TM}$ (p < 0.05), while no significant difference was noted between groups V varnish$^{TM}$ and MI varnish$^{TM}$ (p > 0.05).

• 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 dental hygiene science
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• v.10 no.2
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• pp.95-100
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• 2010

The purposes of this study were to examine the effect of different fluoridated bleaching solution on the changes in physical and chemical characteristics of tooth. Forty-eight bovine incisors were divided into four groups to receive bleaching treatments, over a 14days period, as follows: no treatment; 10% carbamide peroxide (CP) bleaching; 10% CP containing 0.05% fluoride; and 10% CP containing 0.1% fluoride. All the specimens were highly polished and discolored with commercial COCK.Color and enamel changes were determined with colorimeter, microhardness tester, scanning electron microscope, atomic force microscopy. All the collected data were analyzed with one-way ANOVA. After the bleaching, bleached groups showed the color change(E*). Microhardness of 10% CP group decreased after tooth bleaching. But microhardness of containing fluoride bleached groups increased after tooth bleaching. Enamel surface of 10% CP bleached group showed any apparent morphology and roughness changes compared to the enamel which was stored in distilled water only. These results demonstrated that Fluoridated 10% Carbamide Peroxide have appreciable bleaching effect on bovine teeth and were not adversely affects enamel. Supporting influence of fluoride-containing bleaching solution on remineralization could be observed and further research must be carried out in various active environments to confirm these results clinically.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.381-390
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• 2004

The purpose of this in vitro study was to investigate the effects of Nd:YAG laser irradiation and fluorides on acid drink demineralized enamel. The materials were 30 freshly extracted permanent premolars with intact smooth enamel surfaces. They were demineralized with Coca-cola at $37^{\circ}C$ for 12hours and then irradiated by Nd:YAG laser with 6W power, $50mJ/cm^2$ energy density, and 20Hz pulse repetition. After laser irradiation, teeth were treated by three kinds of fluorides; (1)0.05% NaF fluoride solution (2)1.23% APF gel and (3)0.1%F fluoride varnish, microhardness(VHN) and Diagnodent scores were measured and the surfaces of each treated specimens were also observed with SEM under 1500 magnification. The results were as follows: 1. In the change of microhardness(VHN), it decreased to 34.68% from the initial micrhardness, increased to 78.37% after laser irradiation and increased to 82.62% after fluoride treatment, there were significant differences except when it was irradiated and treated with fluoride(P<0.05). 2. In the change of Diagnodent scores, it was decreased to 28.08% from the initial scores after demineralization, and then increased to 59.81% after laser irradiation, and increased to 82.17% after fluoride treatment. Scores were different significantly between the scores of initial, demineralization, laser irradiation and fluoride treatment(P<0.05). All the scores were not different significantly between fluoride types. 3. SEM observation showed that the lased enamel surfaces after demineralization were thermally degenerated and showed molten lava-like appearance and crater with cracks and many microholes.