Assessing the impact of the effect of ozone, casein phosphopeptide–amorphous calcium phosphate, silver diamine fluoride, and hydroxyapatite on remineralization of early carious lesions: An investigation using polarized light microscopic study

Introduction: A popular trend in dental offices, minimal intervention dentistry emphasizes using the least invasive treatments possible to minimize tissue loss and patient discomfort. The earliest indications of dental caries are white spot lesions that can remineralize. Thus, the effects of four different remineralizing agents on early carious lesions were assessed using polarized light microscopy. Materials and Methods: Teeth specimens were immersed in demineralizing agents to create subsurface demineralization. Subsequently, they were randomly assigned to various remineralization regimens, including ozonated water, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), silver diamine fluoride (SDF), and hydroxyapatite. Each specimen underwent treatment twice daily for 3 min and was then placed in artificial saliva. Mineral content was evaluated at baseline, after demineralization, and during remineralization (on the 7[sup.th] and 14[sup.th] day) using a polarized microscopic examination. Results: Group 1 demonstrated the most effective remineralization, consistently displaying the lowest lesion depths at both the 7[sup.th] and 14[sup.th] days. Post hoc comparisons indicate significant differences between group 1 and other groups, emphasizing the potential superiority of the remineralization process in group 1 compared to the other treatment groups. Conclusion: Tooth samples treated with ozonated water, followed by CPP-ACP, SDF, and hydroxyapatite demonstrated a more profound level of remineralization. These agents, namely ozonated water, CPP-ACP, SDF, and hydroxyapatite, prove to be effective in reversing the early stages of enamel caries. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, Medical knowledge. Keywords: Demineralization, dental caries, enamel, hydroxyapatite, ozone, tooth remineralization