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

Abstract

Background: The aims of this study were to investigate the efficacy of CPP‐ACP containing Tooth Mousse on the remineralization of enamel lesions and to compare its efficacy to that of a fluoride‐containing toothpaste.Methods: Permanent teeth were placed in demineralizing solution for 96 hours to produce artificial caries‐like lesions 120–200 μm in depth. They were sectioned into 100–150 μm thick samples and randomly assigned to five groups: for Group A, a fluoridated toothpaste (1100 ppm) was used as a positive control and in Group B, a non‐fluoridated toothpaste was used as a negative control. Tooth Mousse containing CPP‐ACP was tested by three different means: as a toothpaste (Group C); as a topical coating (Group D); and (Group E) as a topical coating after treating the sections with the same fluoridated toothpaste as in Group A.Results: The lesion depth decreased significantly by 7 per cent in Group A, 10.1 per cent in Groups C and D, and 13.1 per cent in Group E (Paired t‐ test, p < 0.05), while in Group B the lesion depth increased significantly by 23 per cent.Conclusions: Based on the data obtained, CPP‐ACP containing Tooth Mousse remineralized initial enamel lesions and it showed a higher remineralizing potential when applied as a topical coating after the use of a fluoridated toothpaste.

Comparison of the newer preventive therapies on remineralisation of enamel in vitro

“…Whereas in the present study, the CPP-ACP and CPP-ACFP crèmes were used as an adjunct to the fluoride treatment with 1450 ppm F. In their study, Kumar, et al (2008), revealed an additive effect for the application of the CPP-ACP crème after the fluoride toothpaste treatment, which is consistent with the results of the current study, however it was not reported whether this additional effect was statistical significance or not.…”

“…The positive effect of CPP-ACP (Tooth Mousse) and CPP-ACFP (MI Paste Plus) in the remineralisation of enamel lesions has been shown in previous in vitro studies (Kumar et al, 2008, Jayarajan et al, 2011, Zhang et al, 2011. However, different methodologies were used in these studies compared to the current study.…”

Impact of Experimental Nano-HAP Pastes on Bovine Enamel and Dentin Submitted to a pH Cycling Model

“…CPP-ACP products have shown an ability to prevent dental demineralization and increase remineralization of enamel and dentin in vitro (12,13), as well as to arrest initial enamel caries lesions in vivo (15)(16)(17). However, due to the lack of clinical trials, there is no consensus about the cariostatic effect of CPP-ACP.…”

“…Pastes containing a complex of casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP), with or without fluoride, have shown potential to prevent dental demineralization, increase remineralization in vitro (10)(11)(12)(13)(14) and to repair initial enamel caries lesions in vivo as well (15)(16)(17). It has been suggested that casein phosphopeptides (CPP) have the ability to stabilize calcium phosphate in solution by binding amorphous calcium phosphate (ACP) with their multiple phosphoserine residues, thereby allowing the formation of small CPP-ACP clusters (18).…”

White Spot Lesions: Prevention and Management During the Orthodontic Treatment

“…Traces of demineralization, which cannot be foreseen, are often discovered at the end of treatment, requiring continued preventive fluoride treatment. In this case it is important to make topical applications of fluorides in a solution, gel or varnish to facilitate surface remineralization of incipient carious lesions [49,50]. Another study concerning remineralization with fluoride after removal of orthodontic devices has shown that the use of a fluoride toothpaste twice a day leads to remineralization after 2 months, and combining fluoride toothpaste and fluoride gels speeds up remineralization (1 month) [51].…”