Abstract
CONTEXT: Dentin, due to its organic content, exhibits a high susceptibility to dental erosion owing to its high permeability to intrinsic acids. A crucial challenge for successful remineralization of demineralized dentin is reestablishing a complete spatial relationship between the mineral and collagen. AIMS: This study aimed to evaluate the synergistic effect of casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) with plant-based dentin biomodifying agents: Grape seed extract (GSE), green tea extract (GTE), and cranberry extract (CE) on biomimetic remineralization of eroded dentin. SETTINGS AND DESIGN: Dentin samples were prepared and subjected to surface microhardness (SMH) analysis at baseline followed by erosive challenge with hydrochloric acid (0.01M) and pH cycling with citric acid (0.05M) and artificial saliva. The samples in all the groups except the control were subjected to surface treatments: CPP-ACPF, GSE + CPP-ACPF, GTE + CPP-ACPF, and CE + CPP-ACPF. SUBJECTS AND METHODS: Samples from all the groups were subjected to Vickers Hardness Tester for Post Treatment SMH analysis. Samples were qualitatively evaluated for changes in ultramorphological characteristics of dentin surface using scanning electron microscopy (SEM) and were quantitatively analyzed for changes in the calcium (Ca)/phosphorous (P) ratio using energy dispersive X-ray analysis (EDAX). STATISTICAL ANALYSIS USED: Data obtained were statistically analyzed using ANOVA, paired samples test, and Tukey HSD test. P value < 0.05 was considered statistically significant. RESULTS: The samples pretreated with GSE showed the highest mean SMH followed by GTE and CE. The difference in % change was significant when GSE was compared to GTE and CE (P = 0.001 and P = 0.000, respectively). SEM pictomicrographs of demineralized dentin samples revealed enlarged and exposed dentinal tubules, and most of these tubules were unobstructed with no obvious sediments. Samples treated with test agents demonstrated amorphous crystal-like deposits occluding the dentinal tubules with higher incidence observed in the groups treated with the combination of the agents. EDAX analysis revealed the highest mean wt% of Ca and P in groups pretreated with GSE followed by GTE and CE. GSE showed the highest mean Ca/P ratio followed by CE and GTE. CONCLUSIONS: The findings of this study demonstrated a synergistic effect when CPP-ACPF was used after pretreatment with plant-based dentin biomodifying agents in causing biomimetic remineralization of eroded dentin.