Nanocomplejo De Fosfopéptido De Caseína-Fosfato De Calcio Amorfo (Cpp-Acp) en Odontología: Estado Del Arte

Abstract

Saliva and external agents containing different concentrations of sodium fluoride (NaF) promote the dental remineralization process. However, these resources may not be sufficient to counteract the multiple factors involved in the process of dental caries, especially in high-risk patients. There are alternatives that have been extensively researched, such as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) which provides essential ions, like phosphate and calcium, acting as an adjuvant in the remineralization process. Manufacturers of CPP-ACP-based products also suggest that it can produce desensitizing effects. This nanocomplex has been used experimentally with some dental cements and adhesive systems, but it is important to clarify the effects of this procedure, and the remineralizing/desensitizing advantages it offers. The objective of this topic review was to present the state of the art on CPP-ACP nanocomplex. In terms of dental caries prevention, this remineralizing option is not better than NaF. CPP-ACP provides a dental desensitizing action, but it is temporary and less effective than other alternatives such as potassium nitrate or NaF. The experimental incorporation of CPP-ACP into dental cements should be controlled for not to compromise the physico-chemical properties of the material. The use of dental products based on this nanocomplex as dental surface pretreatment may decrease the bond strength of adhesive materials, but this effect is material dependent.

Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: an in-vitro study

“…Also, its ACP nanoclusters are small enough to access demineralized areas [43,44]. This is consistent with an additional research, concluding that products containing CPP-ACP have a great tendency to regress enamel white spot lesions due to the incorporation of calcium and phosphate of ACP into the demineralized structure [10,45]. A different supportive meta-analysis determined that CPP-ACP produces excellent remineralization of WSLs, with high surface microhardness regaining, probably through a remineralizing effect.…”

Theobromine versus casein phospho-peptides/Amorphous calcium phosphate with fluoride as remineralizing agents: effect on resin-dentine bond strength, microhardness, and morphology of dentine

“…Behrouzi et al [ 49 ] stated in their study that the remineralization process was accelerated by fluoride, calcium, and phosphorous ions penetrating the HA crystals, increasing their density. They are precipitated on the phosphorylated fibrils of the exposed intertubular dentine collagen [ 50 ].…”

Potential of CPP-ACP and cranberry proantho-cyanidin chewing gum for remineralization of perimylolysis in eating disorders patients

“…CPP with a specific sequence of 'acid motif' in tryptic digestion has been reported to stabilize amorphous calcium phosphate. Based on preliminary research, this nanocomplex can suppress demineralization and improve tooth remineralization [12,13].…”