Remineralization of enamel subsurface lesions in situ by sugar‐free lozenges containing casein phosphopeptideamorphous calcium phosphate

Abstract

Background:The anticariogenic potential of casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP) has been demonstrated using laboratory, animal and human in situ caries models. The aim of this study was to determine the effect of CPP-ACP incorporation into a sugar-free lozenge (pressed mint tablet) on enamel remineralization in a human in situ model. Methods:The study utilized a double-blind, randomized, cross-over design with four treatments: (i) a lozenge containing 56.4mg (3 per cent w/w) CPP-ACP; (ii) a lozenge containing 18.8mg (1 per cent w/w) CPP-ACP; (iii) a lozenge not containing CPP-ACP; and (iv) a no lozenge nil-treatment control. Ten subjects wore removable palatal appliances with four, human-enamel, half-slab insets containing subsurface lesions. Lozenges were consumed, without chewing, four times per day for 14 days duration. After each treatment period the enamel slabs were removed, paired with their respective demineralized control, embedded, sectioned and subjected to microradiography and computer-assisted densitometric image analysis to determine the level of remineralization. Results: The incorporation of CPP-ACP into the lozenge significantly increased enamel subsurface lesion remineralization with 18.8 and 56.4mg of CPP-ACP increasing remineralization by 78 and 176 per cent respectively, relative to the control sugarfree lozenge. Conclusion: This study demonstrates that lozenges are a suitable vehicle for the delivery of CPP-ACP to promote enamel remineralization.

The effect of casein phosphopeptide‐amorphous calcium phosphate on remineralization of artificial caries‐like lesions: an in vitro study

“…12,13,15,27 It has been proposed that the anticariogenic mechanism of CPP-ACP is due to localization of ACP at the tooth surface which then buffers the free calcium and phosphate ion activities, thereby helping to maintain a state of supersaturation with respect to the enamel, so depressing demineralization and promoting remineralization. 8 Several studies have shown that higher concentration of CPP-ACP elicit higher remineralization.…”

“…12,15 Furthermore, the remineralized enamel was generally more resistant to decalcification than untreated enamel. 15 The fact that this effect of remineralization of enamel was not confined to chewing gums as a vehicle was demonstrated by Cai et al 13 In clinical trials in patients with severe xerostomia, CPP-ACP in a mouthrinse revealed positive results in terms of caries prevention 16 and mouth moistening. 17 In vitro, CPP-ACP stabilized calcium phosphate solutions have been shown to remineralize subsurface lesions in human third molar enamel.…”

“…[4][5][6][7] In recent years casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) nanocomplexes have also been demonstrated to have anticariogenic properties in both laboratory animal and human in situ experiments. [8][9][10][11][12][13][14] When delivered in a sugar-free chewing gum, CPP-ACP has also been shown to remineralize enamel subsurface lesions in vivo, independent of chewing frequency and duration. 12,15 Furthermore, the remineralized enamel was generally more resistant to decalcification than untreated enamel.…”

Do enamel microabrasion and casein phosphopeptide-amorphous calcium phosphate affect shear bond strength of orthodontic brackets bonded to a demineralized enamel surface?

“…4 Daily use of casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) has been shown to increase enamel remineralization, and mineralization of artificial subsurface enamel lesions increased more than 78% compared to control samples. 11,12 CPP stabilized ACP, and CPP-ACP clusters formed. 13 These CPP-ACP clusters increase the plaque calcium and phosphate levels and remineralize the enamel.…”

The decreased of Streptococcus Mutans growth after topical application of phosphopeptide amorphous calcium phosphate paste

“…While used with chewing gums and lozenges which contained CPP-ACP for 14 days increased the enamel remineralization. 12,13 This study objectives were to count the amount of Streptococcus mutans in the plaque isolate before and after application of CPP-ACP paste topically in children teeth, in order to find any significance of growth amount of Streptococcus mutans before and after application of CPP-ACP paste topically in children teeth.…”