{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:08:09Z","timestamp":1784290089746,"version":"3.55.0"},"reference-count":49,"publisher":"Operative Dentistry","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n        <jats:sec>\n          <jats:title>Introduction:<\/jats:title>\n          <jats:p>The aim of this study was to evaluate the effects of fluoride-containing remineralization agents on enamel white spot lesions.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Methods and Materials:<\/jats:title>\n          <jats:p>Twenty bovine incisors were cut mesio-distally and occluso-gingivally, creating 80 specimens, and divided into four groups (n=20\/group): 1) control (no treatment); 2) fluoride varnish (Voco Profluoroid 5% NaF Varnish, VOCO Dental, Cuxhaven, Germany); 3) CPP-ACFP (MI Paste Plus with Recaldent, GC Corporation, Tokyo, Japan),; 4) self-assembling peptide (P<jats:sub>11<\/jats:sub>-4F, CURODONT Repair Fluoride Plus, Credentis AG, Windisch, Switzerland). After a three-week demineralization-remineralization cycle, white spot lesions were observed on the specimens. Before applying the remineralization agents, baseline demineralization values were determined using DIAGNOdent 2095, QLF-D Biluminator, SEM-EDS (KaVo Dental, Charlotte, NC, USA), and color values were measured by Vita EasyShade (Vita Zahnfabrik, Bad S\u00e4ckingen, Germany). Remineralization agents were applied once, following the manufacturers\u2019 instructions. The remineralization capacities of these agents and their effects on color change were evaluated at four time points: baseline (T0), demineralization (T1), and remineralization on the seventh (T2) and 30th (T3) days.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Results:<\/jats:title>\n          <jats:p>After 30 days, CPP-ACFP and P<jats:sub>11<\/jats:sub>-4F showed significantly greater Ca (% by weight), F (% by weight), and Ca\/P ratio than the fluoride varnish group (<jats:italic>p<\/jats:italic>&lt;0.05). SEM images revealed that in the groups where the remineralization agent was applied, the pores and tubules were blocked, and the surfaces were covered, whereas these findings were not observed in the control group. Based on QLF-D Biluminator data, P<jats:sub>11<\/jats:sub>-4F application provided more successful fluorescence changes compared to CPP-ACFP and fluoride applications and was statistically more effective in reducing lesion volume and maximum fluorescence loss (<jats:italic>p<\/jats:italic>&lt;0.05). Significant differences were observed among the four groups at the seventh (T2) and 30th days (T3) in the laser fluorescence evaluation with DIAGNOdent (<jats:italic>p<\/jats:italic>&lt;0.05). On the seventh day, the fluoride group exhibited greater effectiveness than the control group, while on the 30th day, the CPPACFP group demonstrated superior improvement over the control group (<jats:italic>p<\/jats:italic>&lt;0.05). According to color change results, applying a remineralization agent was found to be a statistically successful method in restoring the tooth\u2019s original color (<jats:italic>p<\/jats:italic>&lt;0.05). However, there were no significant differences among the treatment groups (<jats:italic>p<\/jats:italic>&gt;0.05).<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Conclusions:<\/jats:title>\n          <jats:p>CPP-ACFP and P<jats:sub>11<\/jats:sub>-4F demonstrated positive effects on remineralization at the seventh and 30th days. Applying a remineralization agent is a viable option for blocking pores and tubules on demineralized enamel. The color change related to the use of the remineralization agent showed a positive effect over time.<\/jats:p>\n        <\/jats:sec>","DOI":"10.2341\/24-048","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T10:22:13Z","timestamp":1732702933000},"page":"78-92","source":"Crossref","is-referenced-by-count":4,"title":["Effects of Fluoride-containing Biomimetic Agents on Remineralization and Color Change of Enamel White Spot Lesions: An In Vitro Study"],"prefix":"10.2341","volume":"50","author":[{"given":"EC","family":"F\u0131r\u0131nc\u0131o\u011fullar","sequence":"first","affiliation":[{"name":"*Ezgi Cansu F\u0131r\u0131nc\u0131o\u011fullar, postdoctoral research fellow, Harvard School of Dental Medicine, Department of Orthodontics, Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AM","family":"Urdin\u00e7","sequence":"additional","affiliation":[{"name":"Asl\u0131han Mediha Urdin\u00e7, professor, Egi University, Faculty of Dentistry, Department of Orthodontics, Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1188","reference":[{"issue":"4","key":"b1","series-title":"Journal of Clinical Microbiology","first-page":"1407","article-title":"Bacteria of dental caries in primary and permanent teeth in children and young adults","volume":"46","author":"Aas\n              J","year":"2008","unstructured":"Aas\n              J\n            , GriffenAL, DardisSR, LeeAM, OlsenI, DewherstFE, LeysEJ, & PasterEJ (2008) Bacteria of dental caries in primary and permanent teeth in children and young adultsJournal of Clinical Microbiology46(4) 1407-1417."},{"issue":"2","key":"b2","series-title":"American Journal of Orthodontics","first-page":"93","article-title":"Incidence of white spot formation after bonding and banding.","volume":"81","author":"Gorelick\n              L","year":"1982","unstructured":"Gorelick\n              L\n            , GeigerAM, & GwinnettAJ (1982) Incidence of 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remineralisation of artificial early enamel lesions adjacent to orthodontic brackets","volume":"10","author":"Jablonski-Momeni\n              A","year":"2020","unstructured":"Jablonski-Momeni\n              A\n            , NothelferR, MorawietzM, KiesowA, & Korbmacher-SteinerH (2020) Impact of self-assembling peptides in remineralisation of artificial early enamel lesions adjacent to orthodontic bracketsScientific Reports10(1) 15132. doi:10.1038\/s41598-020-72185-2"},{"issue":"1","key":"b20","series-title":"Biomimetics","first-page":"17","article-title":"Comparative efficacy of novel biomimetic remineralising technologies","volume":"8","author":"Shen\n              P","year":"2023","unstructured":"Shen\n              P\n            , FernandoJR, YuanY, ReynoldsC, & ReynoldsEC (2023) Comparative efficacy of novel biomimetic remineralising technologiesBiomimetics8(1) 17. doi:10.3390\/biomimetics8010017"},{"issue":"1","key":"b21","series-title":"Cells Tissues Organs","first-page":"78","article-title":"Enamel formation and amelogenesis imperfecta","volume":"186","author":"Jan\n              C-C Hu","year":"2007","unstructured":"Jan\n              C-C Hu\n            , ChunYHP, Al HazzazziT, & SimmerJP (2007) Enamel formation and amelogenesis imperfectaCells Tissues Organs186(1) 78-85. doi:10.1159\/000102683"},{"issue":"3","key":"b22","series-title":"International Journal of Peptide Research and Therapeutics","first-page":"899","article-title":"Self-assembling peptide P11-4: A biomimetic agent for enamel remineralization","volume":"27","author":"Bonchev\n              A","year":"2021","unstructured":"Bonchev\n              A\n            , VasilevaR, DyulgerovaE, & YantchevaS (2021) Self-assembling peptide P11-4: A biomimetic agent for enamel remineralizationInternational Journal of Peptide Research and Therapeutics27(3) 899-907. doi:10.1007\/s10989-020-10136-1"},{"issue":"3","key":"b23","series-title":"Journal of Oral Biology and 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VinayC, & ChandrasekharR (2018) Evaluation of enamel remineralizing potential of self-assembling peptide P 11 -4 on artificially induced enamel lesionsin vitro Journal of Indian Society of Pedodontics and Preventive Dentistry36(4) 352-356. doi:10.4103\/JISPPD.JISPPD_255_18"},{"issue":"4","key":"b37","series-title":"British Dental Journal","first-page":"e6","article-title":"Treatment of early caries lesions using biomimetic self-assembling peptides\u2014A clinical safety trial","volume":"215","author":"Brunton\n              PA","year":"2013","unstructured":"Brunton\n              PA\n            , DaviesRPW, BurkeJL, SmithA, AggeliA, BrookesSJ, & KirkhamJ (2013) Treatment of early caries lesions using biomimetic self-assembling peptides\u2014A clinical safety trialBritish Dental Journal215(4) e6. doi:10.1038\/sj.bdj.2013.741"},{"issue":"2","key":"b38","series-title":"Oral Health and Preventive Dentistry","first-page":"147152","article-title":"The potential of self-assembling peptides for enhancement of in vitro remineralisation of white spot lesions as measured by quantitative laser fluorescence","volume":"15","author":"Golland\n              L","year":"2017","unstructured":"Golland\n              L\n            , SchmidlinPR, & Sch\u00e4tzleM (2017) The potential of self-assembling peptides for enhancement of in vitro remineralisation of white spot lesions as measured by quantitative laser fluorescenceOral Health and Preventive Dentistry15(2) 147152, doi:10.3290\/j.ohpd.a37931"},{"issue":"1","key":"b39","series-title":"BMC Oral Health","first-page":"346","article-title":"Comparison of therapies of white spot lesions: A systematic review and network metaanalysis","volume":"23","author":"Xie\n              Z","year":"2023","unstructured":"Xie\n              Z\n            , YuL, LiS, LiJ, & LiuY (2023) Comparison of therapies of white spot lesions: A systematic review and network metaanalysisBMC Oral Health23(1) 346. 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peptides in post-orthodontic white spot lesions compared to fluoride-based delivery systems: Randomized controlled trialClinical Oral Investigations27(2) 613-624. doi:10.1007\/s00784-02204757-7"},{"issue":"1","key":"b42","series-title":"BMC Oral Health","first-page":"577","article-title":"Self-assembling peptide and nano-silver fluoride in remineralizing early enamel carious lesions: Randomized controlled clinical trial","volume":"23","author":"Atteya\n              SM","year":"2023","unstructured":"Atteya\n              SM\n            , AmerHA, SalehSM, & SafwatY (2023) Self-assembling peptide and nano-silver fluoride in remineralizing early enamel carious lesions: Randomized controlled clinical trialBMC Oral Health23(1) 577. doi:10.1186\/s12903-02303269-4"},{"issue":"1","key":"b43","first-page":"42","article-title":"Treatment of carious lesions using self-assembling peptides Advances in Dental Research","volume":"29","author":"Alkilzy\n              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study","volume":"49","author":"Oshiro\n              M","year":"2007","unstructured":"Oshiro\n              M\n            , YamaguchiK, TakamizawaT, InageH, WatanabeT, IrokawaA, AndoS, & MiyazakiM (2007) Effect of CPP-ACP paste on tooth mineralization: An FE-SEM studyJournal of Oral Science49(2) 115-120. doi:10.2334\/josnusd.49.115"},{"issue":"2","key":"b46","series-title":"Acta Odontologica Scandinavica","first-page":"142","article-title":"Ultrasonic assessment of the effects of self-assembling peptide scaffolds on preventing enamel demineralization","volume":"74","author":"Takahashi\n              F","year":"2016","unstructured":"Takahashi\n              F\n            , KurokawaH, ShibasakiS, KawamotoR, MurayamaR, & MiyazakiM (2016) Ultrasonic assessment of the effects of self-assembling peptide scaffolds on preventing enamel demineralizationActa Odontologica Scandinavica74(2) 142-147. doi:10.3109\/00016357.2015.1066850.ica"},{"issue":"4","key":"b47","series-title":"Journal of 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Prosthetic Dentistry101(3) 193-199. doi:10.1016\/S00223913(09)60028-7"},{"issue":"1","key":"b49","series-title":"Progress in Orthodontics","first-page":"10","article-title":"Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: An in-vitro study","volume":"23","author":"Aref\n              N","year":"2022","unstructured":"Aref\n              N\n             & AlrasheedMK (2022) Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: An in-vitro studyProgress in Orthodontics23(1) 10. doi:10.1186\/s40510-022-00404-9"}],"container-title":["Operative 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