Tarek Nour Shaban, Mohamed Adel Ezzat And Amir Hafez Ibrahim,

ABSTRACT
Objective: This Study Was Conducted To Find Out The Effective Remineralizing Agent In Restoring The Mineral Content Of White Spot Lesion By Evaluating The Effect Of Fluoride Combination With Novamin And CPP-ACP On The Mineral Content Of White Spot Lesion.

Materials and Methods: An 84 Specimen Collected From 42 Of Sound Extracted Human Molar Teeth Were Used In This Study. The Teeth Were Sectioned In A Bucco-lingual Direction Into Mesial And Distal Halves Using A Diamond Cutting Disc At Low Speed Hand Piece Under Water Coolant; Then The Mineral Content Of Each Specimen Was Measured Using Energy Dispersive Analysis X-Ray Spectroscopy (EDAX) To Obtain The Baseline Measurement. After That The Teeth Were Immersed In A Demineralizing Solution In A Proportion Of 2ml Solution/mm2 For 72 Hours To Prompt Caries Like Lesion (white Spot Lesion), Then The Mineral Content Of Demineralized Specimen Were Measured Again By EDAX To Detect The Response Of Enamel Surface To Acid Attack. All Specimens Were Randomly Divided Into Three Main Groups According The Remineralizing Paste Used With 28 Specimens Each, Where The First Is Demineralized Enamel Treated With Fluoride, The Second Demineralized Enamel Treated With CPP-ACP With Fluoride And The Third Is Demineralized Enamel Treated With Novamin With Fluoride. Each Group Was Divided Into Two Subgroups According To PH Cycling Application With 14 Specimens Each, Where The First Subgroups The Specimen Subjected To PH Cycling And Second Represent Without PH Cycling. In Order To Standardize Volume And Application Time Of All Tested Remineralizing Pastes, A 20 Units Of All Tested Tooth Paste Were Applied To Enamel Surface Was Using Insulin Syringe Then The Paste Were Rubbed For 5 Minutes On Specimen Surface By A Micro Brush Then Rinsed Off With Water And Dried With Air Syringe. After The Treated Samples Were Subjected Twice Daily To PH Cycle Protocol Which Consist Of 6 Hours Of Demineralization And 18 Hrs Of Remineralization. However In Without PH Cycle Groups The Treated Specimen Were Immersed Immediately In Remineralizing Solution With Any Demineralization. After That The Changes In Mineral Profile Of Each Specimen Were Measured Using Quantitative Assessment Energy Dispersive Analysis X-Ray Spectroscopy EDAX With Scanning Electron Microscope (SEM). The Mineral Profile Analysis Was Used To Determine The Levels Calcium, Phosphorus.

Results: According To The Ca/p Ratio At The Presence Of PH Cycle The Higher Ratio Recorded By The CPP-ACP Followed By Fluoride Then Novamine. The Same Founded In Without PH Cycle The Higher Ca/p Was Recorded By The CPP-ACP Followed By Fluoride And Finally Novamine. Conclusion: Remineralizing Agents Containing Calcium Phosphate Components Are Able To Remineralized The Early Enamel Carious Lesion. The Fluoride Percentages In Novamin Paste Play An Important Role In Its Remineralization Effectiveness And The Higher Fluoride Concentration Limits And Decreases The Remineralization Potential Of Novamin. The Addition Of Fluoride To CPP-ACP Remineralizing System Provide The Highest Remineralization Tendency With The Highest Potential For Inhibition Of Surface Softening By Acid Challenge.