The Remineralizing and Desensitizing Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) Versus Fluoride Cream Application Following the Use of Lumacool (Teeth Whitening Pen) on Premolars: An Ex-Vivo Trial

Aim: This study sought to compare the remineralizing and desensitizing capabilities of case in phospho-peptide-amorphous calcium phosphate (CPP-ACP) and f luoride cream when applied after Lumacool (a teeth whitening pen) on premolars. Subjects and methods: Fifty-six stained sound human premolars were divided into four equal groups and bleached with different agents. Patient tooth sensitivity was assessed using the Visual Analogue Scale (VAS) at 1, 7, 14, and 28 days postapplication. Teeth were subsequently extracted and prepared for scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and Vickers microhardness testing. Morphological analysis was conducted using SEM, and statistical analysis of paired (matched) data was performed with the Wilcoxon signed rank test. Results: highest mean values were observed at day 28 in Groups 3 and 4 (6.14 ± 1.86 and 6.14 ± 2.04, respectively), while the lowest was in Group 1 at day 1 (0.43 ± 0.54). SEM examination of the enamel surface revealed surface irregularities, cracks, and scratches in the hydrogen peroxide groups, contrasting with the relatively smooth surface in the placebo group. Enamel micro-hardness significantly decreased (p < 0.05) in all groups, with Group 2 and Group 4 being the most affected (p = 0.018). Group 1 showed a moderate decrease (p = 0.043), while Group 3 exhibited minimal change (p = 0.866). Conclusion: Hydrogen peroxide is effective for bleaching. Calcium supplementation improves tooth properties and reduces sensitivity. Fluoride is effective for desensitization. Calcium and fluoride combined offer limited benefits compared to individual use.