CPP–ACP and Fluoride: A Synergism to Combat Caries

Abstract

AimsThe aim of this study is to evaluate and compare the demineralization inhibitory effect, fluoride release at varying time intervals, and antibacterial property of MI varnish and fluor protector varnish.Materials and methodsTwenty-four extracted human premolars were sectioned mesiodistally. The buccal and the lingual halves of the teeth were utilized to evaluate the demineralization inhibitory effect and fluoride release of MI varnish and fluor protector varnish, respectively. To evaluate the demineralization inhibitory effect, 150-μm axial longitudinal section was obtained that was photographed and evaluated under a polarized light microscope. To evaluate the fluoride release, a fluoride-specific ion electrode was used. To evaluate the antibacterial susceptibility, the disk diffusion test (Kirby–Bauer method) was done.ResultsStatistical analysis was done using the Students unpaired t test for intergroup comparison and the p value <0.01 was obtained for all the three parameters, i.e., demineralization inhibitory effect, antimicrobial property, and fluoride releasing property at different time intervals.ConclusionA combination of casein phosphopeptide (CPP)–amorphous calcium phosphate (ACP) in fluoride varnish seems to enhance the caries preventive potential of fluoride varnish and antibacterial activity against Streptococcus mutans.Clinical significanceMI varnish, a combination of CPP–ACP and fluoride varnish could be the future of minimally invasive dentistry as it is minimally invasive yet an effective modality for caries prevention.How to cite this articleAttiguppe P, Malik N, et al. CPP–ACP and Fluoride: A Synergism to Combat Caries. Int J Clin Pediatr Dent 2019;12(2):120–125.

Efficiency of casein phosphopeptide amorphous calcium phosphate versus topical fluorides on remineralizing early enamel carious lesions – A systematic review and meta analysis

“…Like CPP ACP, CPP ACPF has also been found to have better potential in caries prevention than when CPP ACP is used as a monotherapy agent, according to the results of this review. This was also in line with the report of a previous study highlighting the synergistic activity of CPP ACP and fluoride to combat dental caries ( Attiguppe et al, 2019 , Srinivasan et al, 2010 ).…”

Tooth mousse containing casein phosphopeptide-amorphous calcium phosphate prevents biofilm formation of Streptococcus mutans

“…Additionally, CPP-ACP adheres to the salivary pellicle and thus may reduce the attachment of S. mutans [ 29 , 30 ]. Based on these findings, these compounds have been incorporated into pastes and varnishes [ 31 , 32 ]. Application of CPP-ACP paste in addition to regular oral hygiene protocol reduced demineralization (white spot lesions) in clinical studies [ 32 – 34 ].…”

Topical fluoride treatment effectiveness: a systematic review

“…Механизм действия этих соединений и фторидов на уровне кристаллов апатитов эмали различен. Однако использование этих соединений имеет одну общую цель -повышение резистентности эмали к кислотам за счет модификации ее структуры, повышение степени минерализации на молекулярном уровне [12]. Научный и клинический интерес представляет сравнительное изучение не только фторидов, но и комплексных соединений, содержащих ионы Ca, P, F. Проводимые исследования требуют обобщения накапливающихся клинических данных.…”