Remineralization effect of casein phosphopeptide-amorphous calcium phosphate on enamel white spot lesions. A quantitative energy dispersive X ray elemental analysis: An in vitro study

Background: The objective of this study was to evaluate, by means of elemental analysis the mineral density, calcium, and phosphorus weight percent of sound enamel, demineralized and CPP-ACP treated enamel. Elemental analysis allows elemental and isotopic composition of a biologic sample. It can be qualitative (determining what elements are present), and quantitative (determining how much of each are present). INCA Energy 250, Oxford Analytical Instruments Ltd. (UK), energy-dispersive X-ray spectroscopy system for elemental analysis was performed on random assigned samples. Methods: 12 sound premolars were extracted for orthodontic reason. Each tooth was sectioned by using a double-faced diamond microtome under water cooling into three section for a total of 36 samples and randomly assigned to three groups: Group 1 (control), Group 2 (WS: white spot) , Group 3 (WST white spot treated) of 12 samples each. Samples (Group 2 and Group 3) underwent equally to 24 h and 48 h of acid bath duration. Then all the treated samples (Group 3) were coated with CPP-ACP for 5 min before immersion into water twice a day. Group 2 served as control for enamel damage evaluation. Inca Point & ID, an analytic platform software for SEM was used for elemental analysis on samples from Group 1 (C), 2 (WS) and Group 3 (WST) in order to determine the weight % and atomic % presence of Ca and P. Results: The results of the samples analysis from the three Groups show different weight % and atomic% of Ca and P, and clearly reflect the different mineralization rates. Conclusions: 10% Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) complex, promotes remineralization in vitro. The results of this in vitro study completely agree with this statement. Clinical studies to investigate the intraoral effectiveness of topical applications of CPP-ACP on white spot lesions are required to confirm these results.