Başlangıç mine lezyonlarının tedavisinde florid ilave edilmiş Kazein Fosfopeptit Amorfoz Kalsiyum Fosfat(CPP-ACPF ile floridli süt ve suyun etkinliğinin araştırılması
Özet
The Effect of Fluoridated Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACPF) and Fluoridated Milk and Water on Remineralization of Artificial Enamel LesionsThe aim of this in vitro study was to evaluate CPP-ACPF (MI Paste Plus) and 900 ppm F added milk and water on remineralization of artificial enamel lesions.A total of 140 enamel slab samples were prepared to investigate in the laboratory experiments. For this purpose, a total of 35 freshly extracted impacted third molar teeth which completed root formation were split into two pairs as the first pair in buccolingual direction and the second one in mesiodistal direction.All enamel surfaces were immersed in an acidifying gel to create initial lesion formation and a pH cycling protocol as described in the literature was utilized to simulate oral conditions for 4 weeks in order to evaluate the effect of test materials on the artificial enamel lesions.Four different test methods were applied to determine demineralization and remineralization that formed in enamel.After the treatment, Vicker?s microhardness test was used to calculate the total amount of mineral loss or gain on enamel surfaces qualitatively.Inductively Coupled Plasma-Mass Spectromete (ICP-MS) test was conducted to detect Ca ions dissolved from hard tissues as a chemical analysis.Mineralization variations caused by the created artifical enamel lesions on the sound enamel tissues and applied treatment agents were evaluated by using Laser Fluorescence Method (DIAGNOdent).SEM analysis was performed to detect morphological changes occurring in the enamel surfaces of non-treated and treated samples. Moreover, mineral variations of enamel lesions after treatment protocols were calculated by using Energy-Dispersive Spectroscopy (EDS) analysis.Remineralized artificial enamel lesions by MI Paste Plus demonstrated the highest microhardness levels which are statistically significant different (p<0,05) than the all experimental groups such as fluoridated milk, fluoridated water and de-ionized water. The statistical analysis also indicated that there is no significant difference (p>0,05) between the groups treated by fluoridated milk and water.De-ionized water treatment was considered as the control group which showed the lowest microhardness values. The statistical tests for comparison proved that the lowest microhardness of control group was significant different (p<0,05) than the remaining experimental groups.There is no statistically significant difference (p>0,05) between the MI Paste and fluoridated milk treatments to compare amount of Ca ions dissolved from enamel surface in the acid solution. In addition, the measured Ca ions amounts were minimum level in these two groups with respect to the control group and fluoridated water group (p<0,05). Control group and fluoridated water group, however, did not show any significant difference statistically (p>0.05).One of the important outcomes of this study is to prove that a statistically significant difference (p<0,05) between the sound and artificial lesion formed enamel tissues. This result is an indicator that the artificial enamel lesions were created successfully before the treatments.At the end of the treatment procedure, LF values of the test groups (MI Plus Paste, fluoridated milk, fluoridated water) were not found statistically significant difference (p>0,05) to the control group. Therefore, this study is also prove that DIAGNOdent?s specificity and sensitivity is not enough to distinguish re-mineralization abilities of the treatments.The SEM analysis of the enamel specimens treated by MI Paste, fluoridated milk and water, respectively, showed that various morphological surface characteristics differ from the artificial enamel lesion formation. These surface topographies depend on the structure of test materials which were applied to the enamel surfaces.In our research EDS analysis was also performed to determine Ca/P ratios. The EDS analysis indicated that all test materials improved the Ca/PO4 ratios on enamel.As a result, this research concluded that CPP-ACP and also fluoridated milk can be topically preferred to prevent demineralization and enhance remineralization on enamel. The further clinical investigations, however, must be needed to develop the facts drawn by this dissertation.Key words: Chemical analysis, CPP-ACPF, DIAGNOdent, fluoridated milk, microhardness