Journal of South Asian Association of Pediatric Dentistry

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VOLUME 4 , ISSUE 2 ( July-September, 2021 ) > List of Articles


A Comparative Evaluation of CPP-ACP Cream and Fluoride Varnish in Remineralization of MIH-affected Teeth Using Laser Fluorescence

Keywords : CPP-ACP, Fluoride varnish, Laser fluorescence, Molar incisor hypomineralization, Remineralization

Citation Information : A Comparative Evaluation of CPP-ACP Cream and Fluoride Varnish in Remineralization of MIH-affected Teeth Using Laser Fluorescence. J South Asian Assoc Pediatr Dent 2021; 4 (2):117-121.

DOI: 10.5005/jp-journals-10077-3081

License: CC BY-NC 4.0

Published Online: 26-08-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Background: Molar incisor hypomineralization (MIH) affected teeth have enamel with altered mineral content like decreased calcium, phosphorous, and increased carbon leading to porous enamel and subsequent post-eruptive breakdown. The treatment is aimed at the prevention of their breakdown. Various remineralization strategies originally employed for initial carious lesions have been extrapolated for use on these defects. Aim and objective: To evaluate the remineralization potential of CPP-ACP-based cream and fluoride varnish for MIH-affected teeth using laser fluorescence (LF). Materials and methods: Thirty children aged 8–14 years who exhibited intact, demarcated opacities on their first permanent molars or permanent incisors, were randomly divided into two groups using simple randomization technique; group I: professional application of fluoride varnish (n = 15); group II: daily single application of CPP-ACP cream (n = 15). The mineral density was assessed before and after 15 days of application with a DIAGNOdent™ pen (KaVo). Results: The mean change in LF values depicting a change in the mineral density scores was 8.933 ± 5.05 for the fluoride varnish group and 7.133 ± 4.17 for the CPP-ACP group. This decrease was statistically significant for both groups. However, no significant difference was found between the two groups in terms of these changes. Conclusion: Both CPP-ACP cream and fluoride varnish are equally effective in achieving remineralization of MIH-affected teeth.

  1. Weerheijm KL, Duggal M, Mejàre I, et al. Judgement criteria for molar-incisor hypomineralization (MIH) in epidemiologic studies; a summary of the European meeting on MIH held in Athens 2003. Eur J Paediatr Dent 2003;4(3):110–113.
  2. Lygidakis NA. Treatment modalities in children with teeth affected by molar-incisor enamel hypomineralization (MIH): a systematic review. Eur Arch Paediatr Dent 2010;2(2):65–74. DOI: 10.1007/BF03262715.
  3. William V, Messer LB, Burrow MF. Molar incisor hypomineralization: review and recommendations for clinical management. Pediatr Dent 2006;28(3):224–232.
  4. Mittal NP, Goyal A, Gauba K, et al. Molar incisor hypomineralisation: prevalence and clinical presentation in school children of the northern region of India. Eur Arch Paediatr Dent 2014;15(1):11–18. DOI: 10.1007/s40368-013-0045-4.
  5. FDI Commission on Oral Health Research and Epidemiology. A review of the development defects of enamel index: DDE Index. Int Dent J 1992;42:411–426.
  6. Jalevik B. Prevalence and diagnosis of molar-incisor-hypomineralization (MIH). A systematic review. Eur Arch Paediatr Dent 2010;10(2):59–64. DOI: 10.1007/BF03262714.
  7. Fearne J, Anderson P, Davis GR. 3D X-ray microscopic study of the extent of variations in enamel density in first permanent molars with idiopathic enamel hypomineralisation. Br Dent J 2004;196(10):634–638. DOI: 10.1038/sj.bdj.4811282.
  8. Ana B, Silvina C, Lucia B, et al. Comparison of mineral density in molar incisor hypomineralization applying fluoride varnishes and casein phosphopeptide-amorphous calcium phosphate. Acta Odontolog Latinoamericana 2017;30:118–123.
  9. Moriyama CM, Rodrigues JA, Lussi A, et al. Effectiveness of fluorescence based methods to detect in situ demineralization and remineralization on smooth surfaces. Caries Res 2014;48(6):507514. DOI: 10.1159/000363074.
  10. Fridman D, Cortese SG, Biondi AM. Clinical Aspect and Reduction in Mineral Density using Laser Fluorescence in Hypomineralization. J Dent Res Abstract Archives. Argentine Division Meeting (Argentina): 95, 2013. URL: aspect and reduction in mineral density using laser fluorescence in hypomineralization.
  11. Bharti MNP, Aminah M, Singh P. Effect of laser and fluoride application for remineralization of the carious lesion: a polarized microscopic study. Int J Contemp Med Res 2017;4(2):489–492.
  12. Savas S, Kavrìk F, Kucukyìlmaz E. Evaluation of the remineralization capacity of CPP-ACP containing fluoride varnish by different quantitative methods. J Appl Oral Sci 2016;24(3):198–203. DOI: 10.1590/1678-775720150583.
  13. Memarpour M, Fakhraei E, Dadaein S, et al. Efficacy of fluoride varnish and casein phosphopeptide-amorphous calcium phosphate for remineralization of primary teeth: a randomized clinical trial. Med Princ Pract 2015;24(3):231–237. DOI: 10.1159/000379750.
  14. Llena C, Leyda AM, Forner L. CPP-ACP and CPP-ACFP versus fluoride varnish in remineralisation of early caries lesions. A prospective study. Eur J Paediatr Dent 2015;16(3):181–186.
  15. Restrepo M, Jeremias F, Santos-Pinto L, et al. Effect of fluoride varnish on enamel remineralization in anterior teeth with molar incisor hypomineralization. J Clin Pediatr Dent 2016;40(3):207–210. DOI: 10.17796/1053-4628-40.3.207.
  16. Bakkal M, Abbasoglu Z, Kargul B. The effect of casein phosphopeptide-amorphous calcium phosphate on molar-incisor hypomineralisation: a pilot study. Oral Health Prev Dent 2017;15(2):163–167. DOI: 10.3290/j.ohpd.a37928.
  17. Sezer B, Caliskan C, Durmus B, Efficacy of MI Paste for Remineralization in MIH-Affected Incisors: A 3-months Clinical Study. (Abstarct).
  18. Bertacci A, Chersoni S, Davidson CL, et al. In vivo enamel fluid movement. Eur J Oral Sci 2007;115(3):169–173. DOI: 10.1111/j.1600-0722.2007.00445.x.
  19. Ozgul BM, Saat S, Sonmez H, et al. Clinical evaluation of desensitizing treatment for incisor teeth affected by molar-incisor hypomineralization. J Clin Pediatr Dent 2013;38(2):101–105. DOI: 10.17796/jcpd.38.2.92mx26l6n482j682.
  20. Pasini M, Giuca MR, Scatena M, et al. Molar incisor hypomineralization treatment with casein phosphopeptide and amorphous calcium phosphate in children. Minerva Stomatol 2018;67(1):20–25. DOI: 10.23736/S0026-4970.17.04086-9.
  21. Baroni C, Marchionni S. MIH supplementation strategies: prospective clinical and laboratory trial. J Dent Res 2011;90(3):371–376. DOI: 10.1177/0022034510388036.
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