الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
The early stages of dental caries involve enamel demineralization which can be reversed. Attempts have been made to develop new materials to remineralize enamel. Combining different remineralizing agents can be beneficial in enhancing remineralization potential of remineralizing agents.
Study objective: This study aimed to evaluate the remineralizing effect of combining self-assembling peptide P11-4 and casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) compared to using each of the remineralizing agents alone and compared to sodium fluoride varnish on caries-like lesions on enamel in primary teeth.
Materials and methods: Sixty sound extracted primary teeth were used in the study. A 4x4 mm window was made in the middle of the labial surface of each tooth. Teeth were subjected to artificial demineralization and then randomly allocated into 4 groups: group I(5%NaF varnish), group II(CPP-ACPF varnish), group III(P11-4) and group 4(P11-4 + CPP-ACPF varnish). Teeth were sectioned longitudinally into two halves. One half was treated by the remineralizing agent, while the other was left untreated as a negative control. Samples were subjected to lesion depth analysis using confocal laser scanning microscope (CLSM). Additionally, elemental analysis was done using Energy Dispersive X-ray spectrometer(EDX) where the Calcium, phosphorus and calcium/phosphorus ratio were estimated and the surface topography was assessed by Scanning-Electron-Microscope(SEM). Data was recorded and statistically evaluated.
Results: A reduction in lesion depth was found in all groups in comparison to demineralized enamel, with the highest reduction in the combined group. No statistically significant difference was observed between the combined group and P11-4 group (P= 1.00), or between CPP-ACPF and 5%NaF groups (P= 1.00). Both the combined group and P11-4 group showed significantly higher lesion depth reduction than CPP-ACPF and 5%NaF. Elemental analysis showed increases in Ca and Ca/P ratio in all groups, also a reduction in P content in all groups. The highest increase in Ca was in the combined group and in Ca/P ratio was in SAP (P11-4) group with no significant difference between all groups (P= 0.131 and 0.401 respectively). The highest reduction in P content was in the combined group. There was a significant difference between 5%NaF and the combined group regarding percent reduction in P content (P=0.011). No significant difference was found between all the other groups. Examination of surface topographical changes using SEM showed improvement in surface topography after application of all remineralizing agents in comparison to demineralized enamel. A smooth homogenous remineralized enamel surface was obtained in the combined group.
Conclusion: Self-assembling peptide P11-4 with CPP-ACPF proved to be an effective combination in remineralization of early carious lesions in primary enamel.