efficacy of theobromine and sodium fluoride solutions for remineralization of initial enamel caries lesions

Objectives: this study investigated the efficacy of theobromine in comparison with 0.05% sodium fluoride solution for remineralization of initial enamel caries lesions (iecls). materials and methods: ninety non-carious extracted premolars were sectioned longitudinally into buccal and lingual segments. caries-like lesions were induced in each segment using acidified gel. forty-five buccal segments were used for surface microhardness (smh) test, and 45 buccal segments were used for energy-dispersive x-ray spectroscopy (eds). the lingual segments were used as the control group for eds and smh test. the baseline smh was measured with a vickers hardness tester, and the baseline calcium content was analyzed by eds. each test group was divided into three subgroups for treatment with (1) artificial saliva, (2) 1.1 mol/l theobromine, and (3) 0.05% sodium fluoride. remineralization and demineralization were done by daily ph cycling to simulate the oral environment. samples in each group were immersed in treatment solutions for 1 min before and after the remineralizing cycle. after a 7-day cycle, the smh test and eds analysis were performed again. data were analyzed using one-way anova, tukey’s post-hoc test, and paired sample t-test (p<0.05). results: all treatments effectively remineralized the iecls (p<0.05), and theobromine caused the maximum increase in smh, which was significantly higher than the value in sodium fluoride group (mean value of 36.56±4.95 versus 23.25±3.92; p=0.000). eds showed the highest calcium deposition in theobromine group (3.82±1.83wt%). conclusion: theobromine is an effective cariostatic agent, and can be considered as a safe alternative to fluoride in preventive dental care.