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J Dent Res Dent Clin Dent Prospects. 2025;19(4): 227-232.
doi: 10.34172/joddd.025.43997
  Abstract View: 13
  PDF Download: 9

Clinical Dentistry

Original Article

Effect of polyacrylic acid pretreatment before CPP-ACP application in remineralization of demineralized root dentin: An in vitro study

Arezoo Ghasemi 1 ORCID logo, Elmira Jafari Navimipour 1* ORCID logo, Soodabeh Kimyai 1 ORCID logo, Parnian Alizadeh Oskuee 1 ORCID logo, Mehdi Daneshpooy 1 ORCID logo, Ziba Islambulchilar 2 ORCID logo, Sevda Riyahifar 3 ORCID logo

1 Department of Operative Dentistry, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
3 Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*Corresponding Author: Elmira Jafari Navimipour, Email: elmiranavimi@gmail.com

Abstract

Background. This study evaluated the efficacy of polyacrylic acid (PAA) pretreatment before application of casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) in remineralizing demineralized root dentin.

Methods. Thirty-nine dentin specimens from extracted human third molars were prepared. All the specimens were standardized for Vickers microhardness at baseline (VHNba). Then the specimens were randomly divided into three groups (n=13): (1) untreated demineralized dentin, (2) CPP-ACP treatment, and (3) PAA pretreatment before CPP-ACP application. All the specimens were subjected to 72 hours of demineralization. Subsequently, treatments were administered according to group protocols and a 28-day pH-cycling regimen. Then, Vickers microhardness (VHN) was assessed after demineralization (VHNde) and after treatment (VHNre). The difference between VHNre and VHNde was calculated as ΔVHN and compared between the groups. Data were analyzed using one-way ANOVA, repeated-measures ANOVA, and post hoc Bonferroni tests (P<0.05).

Results. Demineralization significantly decreased dentin microhardness in all the groups (P<0.001). In contrast, microhardness values increased significantly after applying the treatment protocol (P<0.001). Specimens that received PAA pretreatment before CPP-ACP application showed a considerably higher ΔVHN than those treated with CPP-ACP alone (P<0.0001). However, neither group returned to the initial values.

Conclusion. Applying CPP-ACP, either alone or after pretreatment with PAA, increased the microhardness of demineralized root dentin and promoted remineralization. Pretreatment with PAA enhanced this remineralization effect, suggesting its potential use in conservative dentin treatment strategies.


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Submitted: 10 Aug 2025
Revision: 13 Dec 2025
Accepted: 22 Dec 2025
ePublished: 31 Dec 2025
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