{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:23:49Z","timestamp":1787747029136,"version":"build-2784847793"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n Dental caries is a chronic microbial disease, characterized by progressive enamel demineralization. Improved understanding of its pathogenesis has shifted dentistry toward minimally invasive biomimetic strategies such as Casein phosphopeptide\u2013amorphous calcium phosphate (CPP\u2013ACP). Chitosan, a natural polysaccharide with antibacterial and biomimetic mineralization properties, has recently emerging as a promising alternative. Hence, this study compared the remineralization efficacy of CPP\u2013ACP and chitosan hydrogel on artificially induced enamel lesions on primary enamel.<\/jats:p>\n <\/jats:sec>\n \n Methodology:<\/jats:title>\n \n Thirty-six extracted human molars were sectioned into four parts: sound enamel (control), demineralized enamel, and two experimental groups \u2013 Group A (CPP\u2013ACP) and Group B (chitosan hydrogel). Demineralization was carried out for 96 h followed by remineralization using a 21-day pH-cycling model with twice-daily application of the respective agents. Energy-dispersive X-ray spectroscopy was used for Ca\/P ratio analysis in all specimens. Surface microhardness (SMH) was assessed using Vickers microhardness testing for all the samples. A separate subset of three samples from each group evaluated under the scanning electron microscopy (SEM) for surface morphological assessment. Statistical analysis was performed using the Kruskal\u2013Wallis and pairwise Mann\u2013Whitney\n U<\/jats:italic>\n -tests (\n P<\/jats:italic>\n < 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Group B demonstrated higher SMH (211.2 \u00b1 32.5) and Ca\/P ratio (1.74 \u00b1 0.08) compared to Group A. Significant differences were observed among the groups. Pairwise analysis showed both CPP\u2013ACP and chitosan hydrogel significantly improved the Ca\/P ratio compared to demineralized enamel (\n U<\/jats:italic>\n = 66.5,\n P<\/jats:italic>\n < 0.001), while the chitosan group demonstrated Ca\/\n P<\/jats:italic>\n values comparable to sound enamel. SEM analysis revealed more uniform enamel-like crystal deposition in Group B.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Chitosan hydrogel demonstrated superior remineralization compared to CPP\u2013ACP, highlights its potential as a nonfluoridated, biomimetic, clinically translatable material for enamel remineralization.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jisppd.jisppd_216_26","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:00:31Z","timestamp":1787673631000},"page":"462-470","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparative evaluation of remineralization and microhardness of demineralized primary enamel treated with casein phosphopeptide amorphous calcium phosphate and chitosan hydrogel: An in vitro study"],"prefix":"10.4103","volume":"44","author":[{"given":"M. Sai","family":"Srujana","sequence":"first","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sridevi","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. J. Sai","family":"Sankar","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Pranitha","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siva Sankar","family":"Kundeti","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepthi Nirmal","family":"Gavarraju","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, 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