ORIGINAL ARTICLE Determining the Effcacy of Three Potential Remineralizing Agents on Artifcial Carious Lesions Valluri Pratyusha Sai 1 , Kakarla Pranitha 2 , Avula Jogendra Sai Sankar 3 , Muktneni Sridhar 4 , Kundet Siva Sankar 5 , Adavikolanu Kesav Ramgopal 6 A BSTRACT Background: Present day, the focus has changed toward increasing the tooth resistance by topical application of remineralizing agents, which has resulted in the remarkable decline in dental caries. However, the remineralizing capacity of these agents remains questionable. Aim: To determine the efcacy of three commercially available remineralizing agents on artifcially created carious lesions on primary teeth. Materials and methods: A total of 30 sound human primary anterior teeth were selected, decoronated, and randomly divided into three groups of 10 each: group I (FAgamin), group II (Theodent Classic), group III (GC Tooth Mousse). Baseline surface microhardness for each specimen was measured using a Digital Micro Vicker’s hardness tester. Later these specimens were demineralized for 96 hours to assess intermediate surface microhardness values. Further, they were subjected to remineralization with their respective remineralizing agents for 14 days with a pH cycling model and fnal surface microhardness scores were assessed to determine the extent of remineralization. Results: The statistical analysis was done using ANOVA and Bonferroni multiple comparison tests, which showed that all the three remineralizing agents exhibited certain amount of remineralization. Group I showed the highest potential compared with the other groups, which was statistically signifcant (p < 0.05). Conclusion: All the three groups demonstrated remineralization of carious lesions by virtue of an increase in surface microhardness. Among the tested agents, 38% silver diamine fuoride (SDF) exhibited a superior remineralizing potential. Keywords: Casein phosphopeptide–amorphous calcium phosphate, Remineralization, Remineralizing agents, Silver diamine fluoride, Theobromine. Journal of Oral Health and Community Dentistry (2020): 10.5005/jp-journals-10062-0063 I NTRODUCTION “An ounce of prevention is worth a pound of cure,” says an old proverb. Accordingly, application of preventive measures is relevant in the management of many orofacial diseases including that of dental caries, a most prevalent global public health problem afecting numerous urban and rural communities. 1,2 Initially, caries dynamics fres up with the drop in the critical salivary pH (5.5) facilitating the growth and proliferation of aciduric and acidogenic bacteria, which further plummet the salivary pH leading to enamel demineralization through mineral loss from surface and subsurface enamel leading to a white spot lesion, cavitation, and pulpal pathology in the later stages. 2,3 The most efective way to prevent tooth decay is to remineralize it in its most incipient early noncaviated stage. Remineralizing agents deliver the ions needed by creating certain surface coatings that act as difusion barriers and thereby decrease enamel solubility by the deposition of minerals within the enamel crystallites. 4 The World Health Organization expert committee observed a decline in the dental caries prevalence in many countries that was attributed to the widespread use of remineralizing agents. 1 Of myriad remineralizing agents invented, fuoride can be considered as the most substantial agent that props up the remineralization to an optimum level. 5 Silver diamine fuoride (SDF) is one unique fuoride containing a remineralizing agent with a high median lethal dose, which indicates its low toxicity along with the added benefit of silver metal that promotes remineralization. 6 The power of cocoa beans with theobromine and milk with casein was also documented to have outstanding remineralization properties. 4,7 However, studies comparing the efects of the aforementioned agents on primary teeth are sparse. Thus, to unearth an appropriate novel remineralizing agent that can beneft the oral health in children, the present in vitro study was aimed to assess and compare the remineralizing potential of one novel fuoridated and two nonfuoridated agents when applied to artifcial carious lesions on primary teeth. M ATERIALS AND M ETHODS After obtaining clearance from the institutional ethical committee, the present in vitro study was planned with a sample size of 30 teeth. The sample included sound human primary caries-free anterior teeth (either extracted for orthodontic reasons, overretained or exfoliated teeth) and were stored in thymol solution until further use. Teeth with dental caries, cracks, white spots, developmental 1–5 Department of Pedodontics and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India 6 Department of Radiation Oncology, NRI Medical College, Chinnakakani, Guntur, Andhra Pradesh, India Corresponding Author: Avula Jogendra Sai Sankar, Department of Pedodontics and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India, Phone: +91 9346550646, e-mail: saisamata@gmail.com How to cite this article: Sai VP, Pranitha K, Sai Sankar AJ, et al. Determining the Efcacy of Three Potential Remineralizing Agents on Artifcial Carious Lesions. J Oral Health Comm Dent 2020;14(1):1–5. Source of support: Nil Confict of interest: None © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons. org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.