Is it Possible to Regain Lost Minerals to Initial Enamel Lesions Using Enamel Matrix Derivatives Combined with Casein Phosphopeptide Amorphous Calcium Phosphate: An in Vitro Study

Abstract

Objective: This study aimed to assess the efficacy of enamel matrix derivatives (EMD) used in combination with casein phosphopeptide amorphous calcium phosphate (CPP-ACP) to recover minerals to the enamel after artificial caries formation.

Methods: Fifty enamel samples were prepared from the buccal surfaces of extracted human third molars. The samples were divided into five groups: (G1) Untreated enamel samples (control), (G2) Application of 500 ppm sodium fluoride (NaF), (G3) CPP-ACP, (G4) EMD, and (G5) CPP-ACP + EMD. All of the samples were placed in an acidic buffer solution for 96 hours to simulate a carious lesion. Ca/P ratios were calculated using energy dispersive X-ray spectroscopy (EDX). After seven days of the remineralization procedure, the mineral contents of the samples were re-measured. All the data were analyzed statistically.

Results: There were no statistically significant differences in the mineral contents of the samples between the groups after demineralization (p>0.05). The Ca/P ratios of G2, G3, G4, and G5 increased significantly (p<0.05) after remineralization. The highest levels of the Ca/P ratio were obtained in G5.

Conclusion: Despite the limitations of this in vitro study, the combined use of CPP-ACP and EMD may increase the remineralization potential. Furthermore, this procedures may be an alternative for providing enamel remineralization in future clinical trials.