DOI: 10.1177/25785478261486500 ISSN: 2578-5478

Comparative Efficacy of CO 2 Laser-Activated CPP-ACP, Nano-Hydroxyapatite, and Self-Assembling Peptide P11-4 on Enamel Remineralization and Pit and Fissure Sealant Adhesion in Demineralized Primary D

Abeer Ali Alshami, Hiba Faisal Kattan
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Aims:

To compare the effects of different remineralizing agents, namely nano-hydroxyapatite (Nano-HA), casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), carbon dioxide (CO 2 ) laser-activated CPP-ACP, and Curodont ™ Repair, on the resin tag length (RTL), shear bond strength (SBS), and calcium/phosphate (Ca/P) ratio of artificially demineralized primary molar enamel.

Material and methods:

A total of 130 caries-free primary molars were subjected to standardized chemical demineralization, following occlusal surface flattening with a flat-end diamond bur. The specimens were randomly distributed into five groups according to the type of remineralization technique ( n = 26): Group 1 (Control), Group 2 (CPP-ACP), Group 3 (CPP-ACP + CO 2 laser), Group 4 (0.15% Nano-HA), and Group 5 (Curodont Repair). After pretreatment, eight samples per group were assessed for Ca/P ratio using energy dispersive spectroscopy. Pit and fissure sealants (PFSs) were applied to all the remaining specimens ( n = 18). RTL was assessed in eight specimens per group using scanning electron microscopy (SEM), whereas SBS was measured in the remaining 10 specimens using a universal testing machine. Failure mode analysis was conducted using stereomicroscopic evaluation. Statistical comparisons were performed using analysis of variance and Tukey’s post hoc test ( p < 0.05).

Results:

Group 4 (0.15% Nano-HA) achieved the highest mean Ca/P ratio (2.27 ± 0.18), significantly superior to all other groups. The longest RTL (54.22 ± 2.45 μm) and highest SBS (10.12 ± 0.21 MPa) were recorded in the Nano-HA group. Conversely, Curodont Repair produced the shortest RTL (23.21 ± 1.43 μm) and weakest SBS (7.89 ± 0.14 MPa) among all tested groups.

Conclusions:

Nano-HA demonstrated the most favorable influence on RTL, SBS, and Ca/P ratio before PFS placement on demineralized primary molar enamel, followed by CPP-ACP with or without CO 2 laser adjunction. Curodont Repair improved the Ca/P ratio but failed to enhance sealant bonding.

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