The effects of sodium hexametaphosphate combined with other remineralizing agents on the staining and microhardness of early enamel caries: An in vitro modified pH‑cycling model

Hamideh Sadat Mohammadipour, Zohreh Faghfour Maghrebi, Navid Ramezanian, Farzaneh Ahrari, Roya Amiri Daluyi

Abstract


Background: This study was conducted to determine the effects of sodium hexametaphosphate (SHMP)
combined with other remineralizing agents on the staining and microhardness of early enamel caries.
Materials and Methods: in This in vitro study The enamel buccal surfaces of 70 bovine incisors
were classified into seven study groups (n = 10). Remineralizing agents were employed alone and
in combination with SHMP in different groups, including: (1) 8% SHMP, (2) 2% sodium fluoride, (3)
2% sodium fluoride + SHMP, (4) Remin Pro®, (5) Remin Pro®+SHMP, (6) MI Paste Plus, and (7) MI
Paste Plus + SHMP. A modified pH‑cycling technique was used to reconstruct the dynamics of
caries. Colorimetric and microhardness analyses were conducted before demineralization (T1),
after caries formation (T2), and after the remineralizing treatment (T3). The data were analyzed by
the one‑way analysis of variance and the repeated measurement analysis (P > 0.05).
Results: After remineralizing cycles, the experimental groups treated with either SHMP alone or
in combination with other materials showed less significant changes in the three variables of color
(Δa, Δb, and ΔL) and the overall color change (ΔE). The enamel caries treated with Remin Pro®
presented the highest color change, while Remin Pro®+ SHMP resulted in the least changes. The
mean value of microhardness after remineralization improved significantly in all groups, except in the
MI Paste Plus + SHMP group that showed the lowest value. In contrast, the highest microhardness
value was recorded for Remin Pro®, being comparable to that of the sound teeth (P > 0.05).
Conclusion: SHMP, either alone or combined with remineralizing agents, created the least staining.
Remineralizing materials alone showed higher surface hardness, while sodium fluoride alone showed
higher surface hardness when combined with SHMP.
Key Words: Casein phosphopeptide‑amorphous calcium phosphate, fluoride , remineralization,
sodium hexametaphosphate

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