Evaluation of the whitening and remineralization effects of a mixture of amorphous calcium phosphate, hydroxyapatite and tetrasodium pyrophosphate on bovine enamel

Young-Eun Lee; Dong-Ok Park; Yun-Sook Jung; Keun-Bae Song

doi:10.11149/jkaoh.2016.40.2.92

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Lee, Park, Jung, and Song: Evaluation of the whitening and remineralization effects of a mixture of amorphous calcium phosphate, hydroxyapatite and tetrasodium pyrophosphate on bovine enamel

Original Article

J Korean Acad Oral Health 2016;40(2):92-99.

Published online: 15 June 2016

DOI: https://doi.org/10.11149/jkaoh.2016.40.2.92

Evaluation of the whitening and remineralization effects of a mixture of amorphous calcium phosphate, hydroxyapatite and tetrasodium pyrophosphate on bovine enamel

Young-Eun Lee¹, Dong-Ok Park¹, Yun-Sook Jung^2,³, Keun-Bae Song^3,

¹Department of Dental Hygiene, Daegu Health College, Daegu, Korea

²Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Korea

³Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea

Corresponding Author: Keun-Bae Song Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, 2177 Dalgubeoldaero, Jung-gu, Daegu 41940, Korea Tel: +82-53-660-6870 Fax: +82-53-423-2947 E-mail: kbsong@knu.ac.kr

Received 12 April 2016 Revised 20 May 2016 Accepted 1 June 2016

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of the present study was to evaluate the whitening effect, morphological and structural changes, and remineralization of the enamel induced by 3 combined agents: amorphous calcium phosphate (ACP), hydroxyapatite (HA), and tetrasodium pyrophosphate (TSP).

Methods

The study was performed on 90 bovine enamel slabs, which were divided into the 6 groups: negative control-distilled water (Group 1); positive control-opalescence F (Group 2); 10% mixed agent (Group 3); 25% mixed agent (Group 4); 50% mixed agent (Group 5); and 100% mixed agent (Group 6). Changes in the shade of the enamel slabs were evaluated using Shade Eye-NCC. Morphological changes were assessed by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) was used to determine the remineralizing effect of the three agents on enamel slabs.

Results

The change in shade of the enamel (ad*) was noted to increase significantly with increase in whitening frequency in all groups. The value of Δn* was significantly greater in all groups except for the negative control group (P<0.001). SEM revealed that the control group, Group 5, and Group 6 had similar morphologies. The fluorescence lesion areas in the 4 mixture-treated group were significantly smaller than those in the positive control group (P<0.001).

Conclusions

These results showed that the mixture of ACP, HA, and TSP was highly effective for bovine enamel whitening and acted by inducing the remineralization of enamel. Clinical significance: We evaluated the applicability of a new mixture containing ACP, HA, and TSP. This mixture would be highly useful in aesthetic dentistry because of its whitening efficiency, which does not compromise the enamel's integrity.

Keywords: Amorphous calcium phosphate, Hydroxyapatite, Remineralization, Tetrasodium pyrophosphate, Whitening

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Fig. 1.

Morphology of the superficial enamel surface after 6 days of treatment in each group (A: Group 1, B: Group 2, C: Group 3, D: Group 4, E: Group 5, F: Group 6) (×2,000).

Fig. 2.

Fluorescent lesions after whitening in each group at 6 days as determined by CLSM; note the demineralized lesion in the center, emits a bright color (A: Group 1, B: Group 2, C: Group 3, D: Group 4, E: Group 5, F: Group 6).

Table 1.

Study group and characteristics of the treatment materials

Group		Contents
Group 1 (n=15)	-	Negative Control, Distilled Water
Group 2 (n=15)	-	Positive Control, 10% Carbamide
Peroxide (CP)
Group 3 (n=15)	10% mixed	ACP 0.3%, HA 0.2%, TSP 0.1%
Group 4 (n=15)	25% mixed	ACP 0.75%, HA 0.5%, TSP 0.25%
Group 5 (n=15)	50% mixed	ACP 1.5%, HA 1%, TSP 0.5%
Group 6 (n=15)	100% mixed	ACP 3%, HA 2%, TSP 1%

ACP: Amorphous calcium phosphate; HA: Hydoxyapatite; TSP: Tetrasodium pyrophosphate.

Table 2.

Shade change (ΔE*) of the specimen according to the whitening times

Group	After 1 day*	After 2 days*	After 3 days*	After 4 days*	After 5 days*	After 6 days*
Group 1^†	6.93±2.49^a	6.13±2.41^a	8.38±3.28^a	7.77±1.70^a	8.37±1.53^a	9.72±1.35^a
Group 2^†	30.4±7.55^b	39.92±8.53^b	47.45±8.14^b	51.21±7.12^b	51.07±6.24^b	54.72±7.14^b
Group 3^†	21.2±4.11^c	26.37±4.55^c	31.52±4.38^c	34.37±3.71^c	34.42±1.86^c	37.30±1.73^c
Group 4^†	25.24±3.61^bc	33.09±5.39^bc	35.75±5.81^c	36.18±6.17^c	38.58±5.54^c	31.94±1.92^c
Group 5^†	26.65±2.89^b	34.22±3.80^b	38.78±2.87^c	41.09±2.94^c	41.32±3.04^c	42.92±0.92^c
Group 6^†	28.90±3.63^b	34.75±4.86^b	37.46±3.81^c	41.21±2.54^c	42.00±3.87^bc	45.72±4.02^c

Values are reported as the Mean±S.D. *Significantly different among the groups at each time point by one-way ANOVA.

^† Significantly different among the experimental times by repeated measures ANOVA.

^a,b,c The same letters indicate no significant different among the groups according to a Tukey's multiple comparison at each whitening time.

Table 3.

Fluorescence lesion depth at 6 days by CLSM

Group	Fluorescence lesion depth (mm)	P value*
Group 1 (n=8)	6.15±0.88^a	<0.001
Group 2 (n=8)	64.45±7.48^b
Group 3 (n=8)	11.13±1.01^a
Group 4 (n=8)	8.49±1.34^a
Group 5 (n=8)	7.03±0.88^a
Group 6 (n=8)	4.98±0.51^a

Values are Mean±S.D. *Significantly different among groups by repeated measures ANOVA procedure.

^a,b The same letters indicate no significant difference between the groups according to a Tukey's multiple comparison.

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