In-vitro investigation of remineralization efficacy of nanotechnological products and herbal-derived agents in primary teeth

Aim: The aim of this study; to evaluate the remineralization efficiency of nanotechnological products such as casein phosphopeptide amorphous calcium phosphate (CPP-ACP), nanohydroxyapatite (nHA), bioactive glass and herbal agents such as cocoa, propolis, grape seed extract, rosemary and ginger in primary tooth enamel caries. Material and Method: In our study, 80 primary tooth enamel samples; healthy enamel, caries group, CPP-ACP, nHA, bioactive glass, cocoa, propolis, grape seed extract, rosemary, ginger were divided into 10 groups. In order to create initial enamel caries, all groups except Group 1 were kept in demineralization solution for 72 hours and then subjected to pH cycle for 7 days. Remineralization materials were applied to the teeth in the other groups, except for groups 1 and 2, for 4 minutes for 7 days. Then, SEM/EDX analysis was performed on all teeth. Data were analyzed with IBM SPSS V23 package program. Statistical analysis was performed using Kruskal Wallis, Dunn and Tukey HSD tests. Significance level was taken as p<0.05. Results: When SEM images were examined, it was observed used in our study formed calcified precipitates on the test surface. When the Ca/P ratios were examined in the EDX analysis, there was a statistically significant difference between the intact enamel group and the CPP-ACP group (p<0.05), while a significant difference was found between the caries group and the CPP-ACP, nHA, bioactive glass and rosemary groups (p<0.05). There was no significant difference between the remineralization materials (p>0.5). Conclusion: It was determined that the most homogeneous SEM image in primary teeth belonged to grape seed extract. It was observed that all the materials we used showed remineralization activity in primary tooth enamel. However, it was determined that CPP-ACP, nHA, bioactive glass and rosemary increased the Ca/P ratio in enamel more. It has been concluded that herbal agents are beneficial in remineralization in enamel caries, which is common in children. Key Words: Cocoa, grape seed extract, rosemary, ginger, SEM/EDX