Study of the Efficacy of Toothpaste Containing Casein Phosphopeptide in the Prevention of Dental Caries: a Randomized Controlled Trial in 12- to 15-Year-Old High Caries Risk Children in Bangalore, India

Rao, Sheetal; Bhat, GS; Aradhya, Shankar; Devi, Aruna M; Bhat, Mohandas

doi:10.1159/000252976

Cited by 56 publications

(56 citation statements)

References 26 publications

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“…For this reason, the effects of dentifrices on dental erosion have been exhaustively studied (12,(22)(23)(24). While some studies have shown that products with bioactive agents such as fluoride, CPP-ACP, and calcium sodium phosphosilicate have the potential to prevent enamel demineralization (20,23,24), other studies have shown no favorable effects of these agents (12,22). @ C I C E d i z i o n i I n t e r n a z i o n a l i…”

Section: @ C I C E D I Z I O N I I N T E R N a Z I O N A L Imentioning

confidence: 99%

Protective effects of a zinc-hydroxyapatite toothpaste on enamel erosion: SEM study

Colombo

Beltrami

Rattalino

et al. 2016

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SummaryAim. The aim of the present in vitro study was to evaluate the protective effects of a zinc-hydroxyapatite toothpaste against an erosive challenge produced by a soft drink (Coca-Cola) using Scanning Electron Microscopy (SEM). Methods. Forty specimens were assigned to 4 groups of 10 specimens each (group 1: no erosive challenge, no toothpaste treatment, group 2: erosive challenge, no toothpaste treatment, group 3: erosive challenge, fluoride toothpaste treatment, group 4: erosive challenge, zinc-hydroxyapatite toothpaste treatment). The surface of each specimen was imaged by SEM. A visual rating system was used to evaluate the condition of the enamel surface; results were analyzed by nonparametric statistical methods. Results. Statistically significant differences were found between the samples untreated and those immersed in Coca-Cola (group 1, 2); the highest grade of damage was found in group 2, while the lowest grade was recorded in the samples of group 4. Comparing the groups, the two analyzed toothpaste tended to protect in different extend. Conclusions. In this study treatment of erosively challenged enamel with Zn-Hap toothpaste showed a clear protective effect. This was greater than the effect observed for a normal fluoride toothpaste and confirmed the potential benefit the Zn-HAP technology can provide in protecting enamel from erosive acid challenges.

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Section: @ C I C E D I Z I O N I I N T E R N a Z I O N A L Imentioning

confidence: 99%

Protective effects of a zinc-hydroxyapatite toothpaste on enamel erosion: SEM study

Colombo

Beltrami

Rattalino

et al. 2016

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“…As stated above, many published in situ studies on the CPP-ACP technology have demonstrated a significant remineralization of enamel subsurface lesions predicting a slowing of caries progression and promotion of lesion regression in an RCT. This prediction has now been validated in 4 published RCTs [Andersson et al, 2007;Morgan et al, 2008;Bailey et al, 2009;Rao et al, 2009]. One RCT demonstrated that CPP-ACP in a sugar-free chewing gum, relative to a normal sugar-free gum, significantly slowed progression and enhanced regression of approximal caries in a population of schoolchildren .…”

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confidence: 92%

“…One RCT demonstrated that CPP-ACP in a sugar-free chewing gum, relative to a normal sugar-free gum, significantly slowed progression and enhanced regression of approximal caries in a population of schoolchildren . Another 2 RCTs demonstrated that CPP-ACP delivered in a tooth cream significantly regressed white-spot lesions in postorthodontic populations [Andersson et al, 2007;Bailey et al, 2009], and recently another RCT showed that CPP and calcium carbonate in a toothpaste formulation, which would spontaneously form CPP-ACP in saliva, significantly reduced caries experience in children compared with a placebo toothpaste [Rao et al, 2009].…”

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confidence: 99%

Casein Phosphopeptide-Amorphous Calcium Phosphate Incorporated into Sugar Confections Inhibits the Progression of Enamel Subsurface Lesions in situ

Walker

Cai²,

Shen³

et al. 2010

Caries Res

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Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been demonstrated to exhibit anticariogenic activity in randomized, controlled clinical trials of sugar-free gum and a tooth cream. Two randomized, double-blind, crossover studies were conducted to investigate the potential of CPP-ACP added to hard candy confections to slow the progression of enamel subsurface lesions in an in situ model. The confections studied were: (1) control sugar (65% sucrose + 33% glucose syrup); (2) control sugar-free; (3) sugar + 0.5% (w/w) CPP-ACP; (4) sugar + 1.0% (w/w) CPP-ACP; (5) sugar-free + 0.5% (w/w) CPP-ACP. Participants (10 and 14 in study 1 and 2) wore a removable palatal appliance containing enamel half-slabs with subsurface lesions, except for meals and oral hygiene procedures, and consumed 1 confection 6 times a day for 10 days. The enamel half-slabs were inset to allow the development of plaque on the enamel surface. Participants rested for 1 week before crossing over to another confection. The appliances were stored in a humid container at 37°C when not in the mouth. After each treatment period, the enamel half-slabs were removed, paired with their demineralized control half-slabs, embedded, sectioned and then analysed using transverse microradiography. In both studies consumption of the control sugar confection resulted in significant demineralization (progression) of the enamel subsurface lesions. However, consumption of the sugar confections containing CPP-ACP did not result in lesion progression, but in fact in significant remineralization (regression) of the lesions. Remineralization by consumption of the sugar + 1.0% CPP-ACP confection was significantly greater than that obtained with the sugar-free confection.

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“…Recently, CPP (without the addition of ACP) has been shown to reduce caries incidence in a clinical trial [Rao et al, 2009].…”

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confidence: 99%

Inhibition of Dental Erosion by Casein and Casein-Derived Proteins

2010

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The application of milk-derived proteins such as casein as anti-erosion agents in oral healthcare products is of current interest. The aim of this study was to investigate the potential of 3 commercially available, milk-derived proteins as agents to inhibit enamel erosion. Aqueous solutions of 0.5% w/v casein, casein phosphopeptide (CPP) or glycomacropeptide (GMP) with and without 300 ppm fluoride (F, as NaF) were investigated with regard to enamel softening and tissue loss, in comparison with a deionised water (DIW) negative control and 300 ppm F positive control. Casein and F reduced enamel surface softening compared to DIW, but CPP and GMP did not (DIW: 58.2% reduction in hardness; F: 13.3%; casein: 21.8%; CPP: 50.8%; GMP: 62.4%). Similar results were obtained with solutions containing protein and F, and the effects were statistically indistinguishable from protein alone (casein + F: 19.1%; CPP + F: 48.2%; GMP + F: 66.1%). By contrast, all protein solutions and F significantly reduced tissue loss (p < 0.050; DIW: 25.8 µm tissue loss; F: 21.6 µm; casein: 20.3 µm; CPP: 20.5 µm; GMP: 20.0 µm). Solutions containing protein and F reduced erosion more than protein alone, but this difference was only significant from protein alone for casein (casein + F: 12.2 µm; CPP + F: 17.3 µm; GMP + F: 18.2 µm). Casein and casein-derived proteins may therefore have the potential to act as agents to reduce or prevent enamel erosion. Furthermore, the erosion-reducing efficacy is not reduced by F, and is in some cases enhanced.

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Study of the Efficacy of Toothpaste Containing Casein Phosphopeptide in the Prevention of Dental Caries: a Randomized Controlled Trial in 12- to 15-Year-Old High Caries Risk Children in Bangalore, India

Cited by 56 publications

References 26 publications

Protective effects of a zinc-hydroxyapatite toothpaste on enamel erosion: SEM study

Protective effects of a zinc-hydroxyapatite toothpaste on enamel erosion: SEM study

Casein Phosphopeptide-Amorphous Calcium Phosphate Incorporated into Sugar Confections Inhibits the Progression of Enamel Subsurface Lesions in situ

Inhibition of Dental Erosion by Casein and Casein-Derived Proteins

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