In Vitro Study Comparing Treatments for Incipient Enamel Lesion Remineralization

Purpose: This study compared the remineralization efficacy of Icon™, 3M™ Varnish™ 5% Sodium Fluoride White Varnish (FV), and 38% Silver Diamine Fluoride (SDF; Advantage Arrest™) on enamel surfaces affected by incipient caries lesions. Methods: Caries-free permanent teeth, extracted for orthodontic or surgical purposes, were obtained from the Pediatric Dentistry Department at UIC College of Dentistry. Enamel samples (4 mm x 5 mm) were prepared, frozen, and subjected to baseline microhardness testing. Samples were randomized into four groups (n=5/group): Icon, FV, SDF, and a control group. Artificial caries lesions were induced and treated per manufacturers’ instructions. Samples were immersed in a saliva-like remineralization solution for seven days, and post-treatment microhardness was assessed at 20 μm intervals to a depth of 200 μm. Statistical analyses included ANOVA with Tukey-Kramer post hoc tests and Generalized Estimating Equation (GEE) modeling. Results: SDF demonstrated the lowest microhardness values, with a mean of 147.24 (SD: 39.76) at 100 μm, significantly lower than FV (276.54; SD: 33.72), Icon (254.59; SD: 30.18), and the control (253.19; SD: 36.16). FV and Icon showed significantly higher microhardness, indicating superior enamel strengthening compared to SDF. No significant differences were found between FV and Icon. Conclusions: When managing incipient caries, all three materials are effective options for addressing early caries lesions. However, FV and Icon provided superior remineralization and surface hardening when compared to SDF.