Comparative evaluation of remineralization potential of four different remineralization agents on human enamel: An in vitro study

The study aimed to assess the remineralizing potential of four different commercially available agents using a Scanning Electron Microscope (SEM), energy dispersive X-ray (EDX) analysis, and Vickers Microhardness (VMH) Test. Forty-four specimens (n = 11 per group) were prepared from extracted teeth. A window of 6 mm × 4 mm was made on all the specimens that represented three zones, namely, sound enamel, demineralized enamel, and remineralized enamel. The zone for demineralized enamel was subjected to four different remineralizing agents; casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), tricalcium phosphate fluoride (TCP-F), calcium sucrose phosphate (CSP), and self-assembling peptide (P11-4). Remineralization (REM) was assessed using VMH; the structural changes were assessed using SEM that was analyzed using EDX analysis. The specimens were subjected to a newer regimen of demineralization. One-way ANOVA followed by post hoc Tukey test was used with a level of significance at P ≤ 0.05. There were no significant differences in VMH between the groups for sound enamel (P = 0.472) and demineralized enamel (P = 0.116). VMH was statistically significantly more for P11-4 and the least for CPP-ACPF (P = 0.011). A post hoc analysis revealed higher VMH for P11-4 compared to CPP-ACPF (P = 0.014) and TCP-F (P = 0.035). SEM showed a homogeneous layer of minerals for all groups except CPP-ACPF. TCP-F reported a higher degree of REM, followed by P11-4 as assessed using EDX analysis. Self-assembling peptide (P11-4) exhibited a higher degree of REM than other remineralizing agents followed by CSP.