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Remineralization of artificial caries lesions using casein phosphopeptide-amorphous calcium phosphate containing probiotic lozenge: an in vitro study #MMPMID40611049
Akbeyaz Sivet E; Kargul B
BMC Oral Health 2025[Jul]; 25 (1): 1086 PMID40611049show ga
BACKGROUND: Concerns regarding enamel demineralization due to the acidic nature of probiotic tablets have led to investigations into potential solutions. This study aimed to investigate the remineralization potential of probiotic tablets containing Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). METHODS: Forty-eight enamel blocks extracted from human teeth were prepared and randomly assigned to four groups (n = 12 per group). Group 1 was treated with a 20 mg CPP-ACP-containing probiotic lozenge dissolved in 5 mL of Phosphate Buffered Saline (PBS) and applied to the enamel surface for 10 min, while Group 2 received the same lozenge dissolved in 10 mL of PBS under identical conditions. Group 3 (Positive Control) was immersed in a remineralization solution containing 1.5 mM calcium, 0.9 mM phosphate, and 0.15 M KCl in 0.1 M Tris buffer, with pH adjusted to 7.0 for 18 h, whereas Group 4 (Negative Control) was exposed only to PBS. Prior to treatment protocols, all specimens were demineralized by immersion in a solution (pH 4.5) for 72 h to induce artificial enamel lesions. Surface microhardness was measured at baseline, after demineralization, and after treatment using a digital Micro-Vickers Hardness Tester. The percentage of surface microhardness recovery (%SMHR) was calculated. Statistical analysis was performed using two-way repeated measures analysis of variance (ANOVA), one-way ANOVA, and the Least Significant Difference (LSD) test. RESULTS: Both CPP-ACP-containing probiotic lozenge groups (Groups 1 and 2) exhibited significant remineralization, demonstrated by a marked increase in surface microhardness values (p = 0.001). Group 1 demonstrated greater remineralization than Group 2 (p = 0.011). The positive control group (Group 3) exhibited the highest microhardness values after 18 h (p < 0.001). The %SMHR values confirmed a dose-dependent remineralization effect of CPP-ACP-containing probiotic lozenges, with higher concentrations yielding greater remineralization. CONCLUSIONS: CPP-ACP-containing probiotic lozenges significantly enhanced enamel microhardness in a dose-dependent manner, suggesting their potential for enamel remineralization.