Remineralization Potential of Gum Arabic versus Casein Phosphopeptide-Amorphous Calcium Phosphate-Fluoride for Demineralized Enamel in Acidic Challenges: In Vitro Study

Aim: To compare the remineralizing effect of gum arabic and casein phosphopeptide-amorphous calcium phosphate-fluoride (CPP-ACP-F). Materials and Methods: Twenty extracted sound human central incisors were selected and divided into four main groups (five specimens each) according to remineralization treatment: group 1, remineralization by gum arabic; group 2, MI Paste Plus CPP-ACP-F; group 3, gum arabic and CPP-ACP-F (MI Paste Plus); and group 4, artificial saliva. Surface microhardness analysis through Vickers hardness number and morphological evaluation using environmental scanning electron microscope were assessed initially to the sound enamel, demineralized enamel, and finally after 28 days of remineralization protocol and cycles of acidic challenges. Data were collected and statistically analyzed with one-way analysis of variance (ANOVA) followed by the Tukey's post hoc test at the significance level P & LE; .05. Results: Intergroup comparisons showed that there was no significant difference between different groups regarding microhardness at baseline, after demineralization and remineralization (P > .05). However, intragroup comparisons showed that there was a significant difference between different time intervals in the gum arabic group and the MI paste group (P > .001). Conclusion: Both gum arabic and CPP-ACP-F were able to regain and maintain surface microhardness. CPP-ACP-F is a very potent remineralizing agent due to its biomimetic remineralization strategy featuring in the treatment of early enamel lesion. Gum arabic could be a promising remineralizing agent although it had a limited initial remineralizing potential. However, the painting on of CPP-ACP-F over the gum arabic varnish could not provide the desired synergistic remineralizing action. Clinical Significance: Biomimetic remineralization of subsurface enamel lesion is the key to success in the management of early enamel lesion such as in CPP-ACP-F.