Effects of casein phosphopeptide–amorphous calcium phosphate with sodium fluoride on root surface conditions in head and neck radiotherapy patients

Effectiveness of root caries preventive and arresting agents in middle age and older adults: a systematic review

“…In patients submitted to red and neck radiotherapy, daily topical applications of CPP-ACP with NaF increased significantly root surface hardness after 12 months, when compared to a non-intervention group (p=0.001 and p<0.001, respectively) [23]. A minor increase in the number of hard surfaces after 1 year of CPP-ACP applications (from 347 to 350 surfaces) and a decrease in the number of hard surfaces for the control group (from 197 to 173 surfaces) were observed.…”

“…Two non-randomized trials were included [22,23]. After their risk of bias assessment, using ROBINS-I tool (Table 4), one paper [22] was considered to have a serious risk of bias, especially due to bias of missing data and measurements of outcomes.…”

“…After their risk of bias assessment, using ROBINS-I tool (Table 4), one paper [22] was considered to have a serious risk of bias, especially due to bias of missing data and measurements of outcomes. The second paper [23] was considered to have a low risk of bias, according to the parameters assessed by ROBINS-I tool. The years of publications were from 2012 to 2016.…”

“…The preventive agents tested were: 10% chlorhexidine diacetate varnish [15], xylitol [16,17], 5000ppm F toothpaste [8,11], 1.5% arginine and 1450ppm F toothpaste [9,10], 38% SDF [12,13], 38% SDF followed by application of potassium iodide (KI) [13], 5% sodium fluoride (NaF) varnish [14], and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) with sodium fluoride [23]. These agents were compared with a placebo [12][13][14][15][16][17] or a non-fluoridated toothpaste [9] or a regular-fluoridated toothpaste (1350-1450ppmF) [8][9][10][11] or a non-intervention group [23]. The mean age of the population, preventive agents (experimental groups) tested, their comparison group(s), sample size (n) and follow-up period are summarized on Table 5.…”

“…The mean age of the population, preventive agents (experimental groups) tested, their comparison group(s), sample size (n) and follow-up period are summarized on Table 5. The methods used to assess the activity of caries lesions were by measuring tissue color and texture by standard visual-tactile examination [9,[11][12][13]23], electrical caries monitoring [9,10], other scoring systems [8,15], and by the International caries detection assessment system -ICDAS [14,16,17,22]. Only half of the studies were specific for root caries treatment and showed beneficial effects of the agents applied to prevent and/or arrest root caries lesions [8-10, 12, 13].…”