Evaluation of mineral loss in primary and permanent human enamel samples subjected to chemical demineralization by international caries detection and assessment system II and quantitative light-induced fluorescence™: An in vitro study

Abstract

Purpose: The purpose of the study was to understand the mineral loss in primary and permanent enamel samples and an attempt is made to standardize the process of chemical demineralization to generate more meaningful results in research studies involving the remineralization of demineralized samples. Materials and Methods: Due to variability among enamel samples theoretically, it is impossible to standardize demineralization by running time-based chemical demineralization cycle without frequent monitoring. Instead of carrying out demineralization cycles for a fixed duration of time, we quantified the mineral loss 24 hourly using the International Caries Detection and Assessment System (ICDAS) and Quantitative Light-induced Fluorescence System (QLF™). Twenty primary and permanent enamel samples were subjected to demineralization, and ICDAS and QLF™ evaluation were done at 0, 24, 48, 72, 96, 120, 144, and 168 h of demineralization. Results: The first visual change in permanent enamel is appreciated at 24 h (ICDAS II code1, QLF™ code1 −16.353 – ΔF) of demineralization, at 48 h (ICDAS II code2, QLF™ code2, −24.515 – ΔF), there was localized white spot lesion in permanent enamel and remained until 96 h (ICDAS II code 2, QLF™ code 2, −25.739 – ΔF) of demineralization. In primary samples, distinct visual change was seen at 24 h (ICDAS II code2, QLF™ code2, −19.431 – ΔF), and at 48 h clinically, there was a distinct visual change, but optically mild enamel breakdown was appreciated (ICADSII code 2 QLF™ code3, −27.201 – ΔF), which remained constant till 120 h of demineralization (ICDAS II code2 QLF™ code3 −37.645 – ΔF). Conclusion: Different samples demineralize at different rates. The demineralization in primary samples was 1.25 times higher than permanent samples. Recommendation: due to inherent variability in the samples continuous monitoring of the demineralization process on a 24 hourly basis is required to standardize the process.

Keywords

• artificial caries
• international caries detection and assessment system ii
• permanent enamel
• primary enamel
• quantitative light-induced fluorescence