Comparative Evaluation of Remineralization Potential and Surface Microhardness of Three Different Remineralizing Agents on Artificial Enamel Lesions: An In vitro Study

Abstract Aim and Objective: The aim and objective of this study were to evaluate and compare the remineralizing potential of calcium sucrose phosphate (Toothmin), fluoride-hydroxyapatite-xylitol (Remin Pro) and casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) (GC Tooth Mousse) and their impact on surface microhardness of enamel using confocal laser microscopy and Vickers microhardness tester, respectively. Materials and Methods: Eighty sound human premolars extracted for orthodontic or periodontal reasons were collected. Random allocation of 80 samples was done into five experimental groups ( n = 16). After derooting, crowns were embedded in an acrylic resin mold with the buccal surface positioned upward, lying flat, and parallel to the horizontal plane. All the samples in Group 1, 3, 4, and 5 were kept in demineralizing solution for 5 days until a white spot lesion was created on the surface of the enamel. Samples were washed with deionized water and stored in artificial saliva. The samples in Groups 3, 4, and 5 were treated with the respective remineralizing agent. Samples of each group ( n = 15) were divided into two subgroups, i.e., Subgroups A and B for confocal laser microscopic and Vickers microhardness assessment, respectively. Results: Maximum depth of remineralization was seen in calcium sucrose phosphate (197.94 ± 11.30) followed by the CPP-ACP (185.21 ± 11.20) and least in the fluoride-hydroxyapatite-xylitol (161.91 ± 14.39) group. Maximum microhardness increase was seen in the calcium sucrose phosphate (318.31 ± 14.22) followed by the CPP-ACP (286.38 ± 8.67) and least in fluoride-hydroxyapatite-xylitol (236.06 ± 16.71) group and difference was statistically significant ( P < 0.001). Conclusion: Calcium sucrose phosphate showed the highest remineralization depth and greater increase in surface microhardnesss of enamel followed by CPP-ACP and fluoride-hydroxyapatite-xylitol, and the difference was statistically significant.