Effect of Fluoride-incorporated Bioactive Glass Toothpaste on Remineralization of Primary Enamel Lesions: An In-Vitro Study

Aims: This study aimed to evaluate the enamel remineralization effect of fluoride-incorporated bioactive glass (F-BG) toothpaste on artificial subsurface caries in primary teeth. Materials and Methods: Forty sound primary maxillary incisors were subjected to a demineralizing solution for four days to induce artificial enamel caries. The teeth were randomly divided into four experimental groups (n = 10 per group): Group I, F-BG toothpaste (530 ppm fluoride) (BiominF (R)); Group II, 0.22% sodium fluoride toothpaste (1000 ppm fluoride) (Colgate (R)); Group III, 0.32% sodium fluoride toothpaste (1450 ppm fluoride) (Colgate (R)); and Group IV, deionized water as a control. Over the course of seven days, each specimen was treated with a slurry of the respective toothpaste twice daily, followed by pH cycling to simulate oral conditions. Mineral density (MD) values were measured at depths of 0, 40, 80, and 120 mu m using micro-computed tomography (micro-CT) before and after the pH cycling. The percentage of remineralization was calculated based on changes in MD. Statistical comparisons among the groups were made using one-way analysis of variance (ANOVA), followed by post-hoc Bonferroni tests, with a significance level set at P < 0.05. Results: At depths of 0, 40, and 80 mu m, both F-BG toothpaste (Group I) and the 1450 ppm fluoride toothpaste (Group III) demonstrated significantly higher remineralization than the 1000 ppm fluoride toothpaste (Group II) and the control group (Group IV) (P < 0.05). No significant difference in remineralization was observed between Group I and Group III (P > 0.05). At a depth of 120 mu m, none of the test groups showed significant remineralization compared to the control group. Conclusions: The fluoride-incorporated bioactive glass toothpaste (530 ppm fluoride) demonstrated remineralization effects on enamel comparable to those of the 1450 ppm fluoride toothpaste in terms of both surface and subsurface enamel restoration in primary teeth. Clinically, this suggests that F-BG toothpaste may be a viable alternative for remineralization therapy in pediatric populations, especially in situations where lower fluoride concentrations are preferred for young children. Further long-term studies are needed to assess the clinical durability and efficacy of F-BG toothpaste in caries prevention and management.