In Vitro Effect Of Duraphat,GC Tooth Mousse And Fluoride-containing Toothpaste On The Remineralization Of Enamel White Spot Lesions

White Spot Lesions is a common phenomenon during and following fixed orthodontic treatment caused by enamel demineralization. Fixed orthodontic appliances make a challenge for conventional oral hygiene procedures and provide greater surface area for plaque accumulation. They not only limit the self-cleansing ability of saliva, lips, tongue, and cheeks, but also create a difficult access for toothbrush. The acidic byproducts of the bacteria in plaque are responsible for the optical low p H, subsequent enamel demineralization and formation of white spot lesions.The objective of this study was to determine the efficacy of Duraphat, GC tooth mousse and fluoride-containing toothpaste in improving the remineralization of artificial enamel white spot lesions.Method:42 bovine enamel blocks were made, two blocks were for surface observation using SEM as the baseline, other 40 blocks were divided into 4 groups of 10 each after their surface microhardness testing. All blocks were subjected to surface demineralization(p H 4.5, 24h) to produce artificial white spot lesions, followed by surface microhardness testing. Then the 4 groups were subjected to following treatments respectively: Group 1: covered with Duraphat for 12 h, followed by immersing in artificial saliva for 12 days; Group 2: Covered with GC tooth mousse for once(1min) a day, then immersed in artificial saliva, repeated 12 days; Group 3: immersed in fluoride-containing toothpaste slurry for 3min twice a day(8:00am and 8:00pm), then immersed in artificial saliva, repeated 12 days; Group 4(control): only immersed in artificial saliva for 12 days. Finally, the surface microhardness of each enamel block was tested and surface microstructures were observed under SEM.Results:1. The surface microhardness were significantly lower than baseline microhardness values after demineralization(P<0.05). There was no statistically significant difference in surface microhardness values between the four groups. Some porous defects can be observed under SEM.2. The surface microhardness of all the demineralized enamel increased significantly after treatment(P<0.05). Some newly formed hydroxyapatite can be observed under SEM, and energy spectrum analysis can prove that.3. The effects of remineralization in all the four groups were different from each other: with an increase of(60.55±14.05)% for Duraphat,(67.69±11.74)% for GC tooth mousse,(52.82±3.61)% for fluoride-containing toothpaste and(20.43±5.91)% for only artificial saliva.Conclusion:1. Artificial saliva can improve the remineralization of artificial enamel white spot lesions.2. All the three experimental groups showed a statistically significant effect of remineralization than artificial saliva.3. All the three remineralizing products tested were able to accelerate the remineralization of white spot lesions, and Duraphat and GC seem to be more effective than fluoride-containing toothpaste.