Efficacy of a Remineralization Protocol Using Bleaching Gel with ACP

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Objective: To examine the efficacy of a remineralization protocol using professionally dispensed bleaching gel with added Amorphous Calcium Phosphate (ACP). Methods: Six healthy subjects (18-64y), with at least two incipient Class 1 or Class 2 lesions on the posterior maxillary teeth, were recruited to participate. After a baseline evaluation, the subjects were instructed to wear non-reservoir trays containing 16 % carbamide peroxide and ACP gel (NiteWhite Excel, Discus Dental), once daily, for a minimum of three hours over the course of the six month trial. After two weeks, patients returned for saliva and bacterial tests which were repeated at 1-month, 2-month, 3-month, 4-month, 5-month, and 6-month appointments, with the exception of digital radiographs, which were collected at baseline, 3-month and 6-month. Remineralization power was analyzed quantitatively by change between baseline and subsequent time periods. Appropriate statistical tests were conducted between each independent variable where applicable. Results: Data from 21 occlusal or interproximal incipient lesions was analyzed. DIAGNOdent values showed a decreasing trend in all subjects (Figure 1). Four subjects maintained plaque scores of zero after baseline evaluation, and all six subjects scored a gingival index score of zero after baseline evaluation. No sensitivity or discomfort was reported by any subject throughout the study. All subjects demonstrated an increase in stimulated salivary pH after chewing a paraffin pellet for 5 minutes. Using digital subtraction radiography to compare radiographs taken at baseline, 3 month and six month evaluations, no statistically significant difference in the mineral composition of the investigated lesions was observed. Analysis of digital photographs revealed all subjects achieved a lighter shade of enamel color due to bleaching component of ACP gel. Conclusion: After six months of daily ACP gel application, no evidence of remineralization or demineralization, was demonstrated. This protocol was not proven to be effective for remineralization for the duration. Supported by Discus Dental