Enamel Caries Clinical Trial
Official title:
Effect of Different Over-the-counter Toothpastes on Enamel Remineralization: A Double Blinded Randomized Clinical Trial
This study will be conducted to compare between recent over-the-counter toothpaste (Novamin & Fluoride) and regular over-the-counter toothpaste (Sodium Fluoride) in remineralization potential, so as to be able to know which of the toothpastes will have a better remineralization potential on demineralized enamel.
Statement of problem:
Dental caries has been recognized as a dynamic process that results from an imbalance between
the physiologic demineralization and remineralization of tooth structure. It has been well
established that tooth undergoes cyclic demineralization of enamel crystals with periods of
remineralization resulting from re-precipitation of calcium and phosphate ions from the
saliva. If the process of demineralization dominates, caries result. However, if
remineralization dominates along with removal of bacterial infection, enamel integrity gets
restored. This basic knowledge of carious process brings us to an understanding that by
controlling the amount, pattern and rhythm of demineralization and remineralization, carious
lesions can either be controlled from progressing further or can be reversed. Several decades
ago it was noted that clinically detectable white-spot lesions could be hardened; various
scientific methods have been advocated for arrest and the reversal of incipient caries lesion
by either decreasing the solubility of the mineral present or by increasing the mineral
content of the previously demineralized tooth. Since remineralization occurring naturally in
oral environment is often inadequate for maintaining strong decay free enamel and dentin, the
process needs to be augmented by using some external means. It has been proposed that a
simultaneous supply of calcium, phosphate and fluoride ions might serve as an invaluable tool
to remineralize and strengthen the tooth structure by formation of calcium fluorapatite.
Fluoride as a constituent of drinking water and in the form of various topically applied
products especially over-the-counter toothpastes have a long successful history of use as a
caries preventive agent.
NovaMin is claimed to release calcium and phosphate ions intraorally to help the self-repair
process of enamel. A silica-rich surface layer forms through poly-condensation of hydrated
silica groups on which precipitation of ions happens which crystallizes over time to form a
hydroxyl-carbonate apatite. Although it is used extensively as a desensitizing agent reports
also claim that the chemical reactions that promote apatite formation may enhance the
remineralization. But there is limited clinical research to ascertain if there is any
synergistic effect on combining anti-cariogenic activity of fluoride ions with these
remineralization systems.
Direct benefit of the research to the human volunteer:
- Have better remineralization for initial white spot carious lesions using recent Novamin
technology.
- Gain the other advantages for Novamin technology on the gingival health as well as
dental health.
- Patient will know the proper brushing technique as he would be given instructions about
this during the study.
- Patient will get to know the difference in efficiency of different over-the-counter
toothpastes especially those assigned in the investigator's study.
Scientific value and social Benefits:
- Determine whether the new Novamin technology results are worth and have good efficient
remineralization potential or not.
- Know more conservative mean for repair of demineralized areas in teeth.
- Have proper data base about difference in over-the-counter toothpastes.
Research question:
Will recent over-the-counter toothpaste (Novamin & Fluoride) be better than regular
over-the-counter toothpaste (Sodium Fluoride) in remineralization of white spot lesions in
adult patients who are having initial white spot carious lesions?
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