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Micro-CT and FE-SEM enamel analyses of calcium-based agent application after bleaching

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Abstract

Objectives

The objective of the present study is to evaluate the effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on bleached enamel.

Materials and methods

A bleaching agent (35% hydrogen peroxide) was applied, 4 × 8 min on premolar teeth (n = 8). A CPP-ACP paste was applied for 7 days. Prior and post-treatment, microtomography images were obtained and 3D regions of interest (ROIs) were selected, from outer enamel, extending to 110.2-μm depth. CT parameters of structure: thickness (St.Th), separation (St.Sp), and fragmentation index (Fr.I.) were calculated for each (ROI). Data was submitted to paired t tests at a 95% confidence level. The samples were evaluated at 3000 to 100,000 magnification. Quantitative analysis of enamel mineral content was also determined by SEM EDX.

Results

There was a significant increase in structure thickness and calcium content. The phosphorus content increased after bleaching. There was also a decreased separation and fragmentation index on the outer enamel to a depth of 56.2 μm (p < 0.05). There were no changes at 110.2-μm depth for the bleaching CPP-ACP association. A covering layer and decreased spaces between the hydroxyapatite crystals appeared around the enamel prisms, 7 days after the CPP-ACP application.

Conclusions

The application of a CPP-ACP provides a compact structure on the enamel’s outer surface, for 7 days, due to calcium deposition. CT parameters seem to be a useful tool for mineralizing and remineralizing future studies.

Clinical relevance

CPP-ACP neutralizes any adverse effects on enamel surface when applied during a week after bleaching and minimizes any side effects of the bleaching treatment due to a more compact structure.

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Acknowledgements

This work was supported by the CNPQ-The Brazilian National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico) [#142750/2008-5]. Mr. Phil Salmon, application scientist at Bruker micro-CT, is acknowledged for his technical support.

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Authors and Affiliations

  1. Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-900, Brazil

    Mauricio Neves Gomes & Carlos Eduardo Francci

  2. Post-graduate Programme in Dentistry, School of Dentistry, Paulista University–UNIP, Av. Dr Bacelar 1212, Vila Clementino, São Paulo, SP, 04026-002, Brazil

    Flávia Pires Rodrigues

  3. Department of Restorative Dentistry School of Dentistry Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, R. Gilberto Studart, 770/901, Cocó, Fortaleza, CE, 60190-750, Brazil

    Flávia Pires Rodrigues

  4. Biomaterials Science Research Group, School of Dentistry, University of Manchester, Oxford Road, Manchester, M13 9PL, UK

    Nick Silikas

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  1. Mauricio Neves Gomes
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Correspondence to Mauricio Neves Gomes.

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The work was supported by the CNPQ-The Brazilian National Council for Scientific and Technological Development.

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All procedures performed in studies involving human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments; it has been approved by the relevant institutional ethical committee.

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Gomes, M.N., Rodrigues, F.P., Silikas, N. et al. Micro-CT and FE-SEM enamel analyses of calcium-based agent application after bleaching. Clin Oral Invest 22, 961–970 (2018). https://doi.org/10.1007/s00784-017-2175-2

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