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Background: Despite improved oral hygiene regime and availability of preventive formulations, dental caries continues to be a global dental problem. Calcium sucrose phosphate (CaSP) is a remineralizing agent with cariostatic action, which is commonly available in the form of tooth cream. Considering the paucity of evidence, this systematic literature review aims to evaluate the remineralizing efficacy of CaSP. Methodology: The review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Various databases, including PubMed, Cochrane Central, and Google Scholar, were searched until March 15, 2018 and were assessed for inclusion by two independent reviewers. The primary outcome was to assess the remineralizing efficacy of CaSP, and the secondary outcome was to assess the potential of CaSP in arresting white spot lesion(s) on enamel. Results: Out of 2,876 articles, only 13 were qualified for inclusion. Included studies presented a low risk of bias for the following items: caries-free teeth or restoration, and adherence to manufacture’s instruction for the usage of remineralizing agent in the risk of bias scale. Ten studies reported an increase in the microhardness of enamel after CaSP application, and three studies reported the effect of CaSP on arresting white spot lesion(s). CaSP was found to be a better remineralizing agent in comparison to casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) and other remineralizing agents in terms of increasing microhardness of enamel. In addition, CaSP application was also found to have a beneficial effect in restoring the color of white spot lesion(s) to that of normal enamel. Conclusion: CaSP tooth cream was found to be an effective remineralizing agent, compared to others, such as CPP-ACP and CPP-ACPF, in terms of increasing the mean microhardness of enamel and arresting white spot lesion(s).

Orthodontic treatments involving missing or compromised first permanent molars are often challenging cases to treat considering the loss of potential anchor tooth. The case series presents orthodontic treatment in three patients with mutilated/ absent first permanent molars. The treatment goals were to be accomplished by extraction of compromised teeth and retention of healthy dentition. The diagnosis and problem list needed extractions to accomplish the treatment goals. The possibility of extracting compromised first permanent molars instead of other healthy teeth was considered. A setup was done to determine the final occlusion in asymmetric extraction cases. Fixed appliances were used with simple mechanics without any additional anchorage devices. Case-based retention protocols were followed. All the three patients achieved the predetermined treatment objectives of improved esthetics and healthy and stable functional occlusion. The simple and efficient mechanics and finishing techniques for comprehensive orthodontic treatment with first molar extractions presented in the report should help clinicians when treating similar patients.

Treatment of a patient with cleft lip and palate can be challenging. A 10-year and 10-month-old girl presented with uneven and crowded teeth. She had unilateral cleft lip and palate on left side for which she had undergone primary lip repair and palatoplasty when she was younger. On examination, she had concave facial appearance, crossbite of upper arch with reverse overjet of 2 mm, wits appraisal of 6 mm and impacted 23. She was treated with two-phase orthodontic treatment; growth modification appliances followed by fixed mechanotherapy. Total treatment time was 5 years. 1-year follow-up shows that results have been stable with good facial aesthetics and functional occlusion.