Comparative Evaluation of Remineralization Efficacy of a Novel Proanthocyanidin Biovarnish with Fluoride Varnish on Primary Teeth: An In Vitro Study.

Aims and background: Early dental caries are caused by subsurface demineralization of enamel and manifests 0.0015 as noncavitated, white lesions. Remineralization is a process that replaces lost mineral ions in demineralized enamel. Saliva naturally aids in remineralization. However, this process is slow and can be hampered under cariogenic conditions. Fluoride has been a significant caries-preventive agent, promoting remineralization, and preventing demineralization. However, interest in non-fluoridated treatments has increased due to concerns about dental fluorosis. Proanthocyanidins (PACs), which are extracted from grape seeds, have remineralization potential owing to their capacity to chelate calcium and phosphate ions. Materials and methods: This study examined the remineralization effectiveness of a fluoride varnish and a PAC biovarnish on artificially induced dental caries in vitro. Grape seeds were used to extract PACs to create a biovarnish. Three groups of 60 primary molar teeth each-control (no treatment), fluoride varnish, and PAC varnish-were used. The sample tooth was immersed in a demineralizing solution for 4 days to produce artificial caries lesions. Remineralization treatments were administered twice a day for 7 days after demineralization. Changes in surface topography and enamel hardness were evaluated by scanning electron microscopy (SEM) and Vickers enamel microhardness testing (VEMH). Results: One-way ANOVA (analysis of variance) revealed significant differences (p = 0.00) after remineralization, with the PAC varnish group showing the highest (VEMH) values. SEM analysis showed effective remineralization with PAC varnish, presenting a surface similar to sound enamel. Conclusion: The novel PAC biovarnish demonstrated superior remineralization efficacy compared with fluoride varnish, suggesting it as a promising alternative for fluoridated caries prevention treatments. Clinical significance: The study demonstrates that PAC biovarnish is a highly effective alternative to fluoride varnish for enamel remineralization, potentially reducing the risk of dental fluorosis. This offers a promising nonfluoridated option for caries prevention and management. How to cite this article: Baskar R, Srinivasan D, Eagappan AR S, et al. Comparative Evaluation of Remineralization Efficacy of a Novel Proanthocyanidin Biovarnish with Fluoride Varnish on Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(10):1187-1193.