{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:23:55Z","timestamp":1787772235391,"version":"build-2784847793"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study aimed to compare the remineralizing potential of casein phosphopeptide\u2013amorphous calcium phosphate fluoride (CPP-ACPF) varnish alone and CPP-ACPF varnish after applying papain gel, quantitatively using LASER fluorescence readings and qualitatively using scanning electron microscopy (SEM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A total of 108 permanent teeth with white spot lesions were divided into Group I: papain gel applied before CPP-ACPF varnish and Group II: CPP-ACPF varnish alone. Remineralization was monitored with DIAGNOdent laser fluorescence readings at baseline, 1, 3, 6, and 9 months. In addition, we randomly selected three samples from each Group after treatment for SEM evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Statistical analysis revealed no significant difference in remineralization efficacy between the two groups. However, the percentage reduction in DIAGNOdent readings from baseline to 9 months was significantly higher in Group I than in Group II. SEM analysis supported these findings by showing better surface integrity in Group I samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although overall remineralization efficacy did not differ significantly between groups, the combination treatment (papain gel + CPP-ACPF varnish) demonstrated increased longevity of preventive outcomes compared to CPP-ACPF varnish alone. The trial was prospectively registered at CTRI under registration number 2020\/01\/022962.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jisppd.jisppd_537_25","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:01:24Z","timestamp":1772175684000},"page":"113-120","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effect of papain gel pretreatment on the remineralizing potential of casein phosphopeptide\u2013amorphous calcium phosphate fluoride varnish in white spot lesions: A randomized controlled trial"],"prefix":"10.4103","volume":"44","author":[{"given":"Geetika","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Paediatric and Preventive Dentistry, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afroz Alam","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Preventive Dentistry, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garima","family":"Jindal","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Preventive Dentistry, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richa","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Preventive Dentistry, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev Kumar","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Preventive Dentistry, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"R1-20260227","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1600-0528.1999.tb01989.x","article-title":"Prevention and reversal of dental caries:Role of low level fluoride","volume":"27","author":"Featherstone","year":"1999","journal-title":"Community Dent Oral Epidemiol"},{"key":"R2-20260227","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/j.1834-7819.1997.tb00138.x","article-title":"Enamel demineralization during orthodontic treatment. 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