Increasing the efficiency of CPP-ACP to remineralize enamel white spot lesions

Objectives: To compare the remineralization efficacy of using the MI paste plus according to manufacturer's instructions to MI varnish and to using a modified method of MI-paste plus application. Materials and Methods: 100 enamel specimens were obtained from the buccal and lingual surfaces of 50 extracted human non-caries third molars. All specimens were challenged by a buffered demineralization solution for 4 days, and were divided in 4 groups with 25 specimens in each group. 25 demineralized specimens had MI paste plus applied for 4 min and then wiped out (MI), 25 specimens had MI paste applied followed by application of SE-bonding agent (MI + Bond), 25 specimens had MI Varnish applied according to manufacturer instructions (MI Varnish) the rest of specimens served as controls (C). All specimens were stored for 7 days in artificial saliva. All specimens had their surface hardness (SH) measured by micro-hardness tester before/after the acidic challenge and after the treatment procedures. After the SH test all specimens were cross-sectioned to obtain 100-150 micron thickness specimens to observe the lesion depth before/after treatment by the TMR (Transverse Micro Radiography) technique. Results: TMR experiment showed that (MI + Bond) and (MI varnish) groups recorded significant decrease in lesion depth and mineral loss of the tested subsurface lesion p < 0.05. (MI + Bond) group scored the highest significant regain of surface micro hardness results p < 0.05. Conclusion: (MI varnish) and the modified application of MI paste are methods that can increase the efficacy of CPP-ACP in remineralizing the enamel surface lesions.