Effectiveness of CPP-ACP and fluoride products in tooth remineralization

Int J Dent Hyg. 2022 Nov;20(4):635-642. doi: 10.1111/idh.12542. Epub 2021 Nov 9.

Abstract

Objectives: To compare the effectiveness of the casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP) in the in situ remineralization of enamel exposed with two different degrees of preformed enamel lesions.

Methods: One hundred and sixty 3 × 3 × 2 mm human enamel slabs were demineralized and divided into two subgroups according to the baseline surface hardness (SH = B1≤150 and B2 >150). During each of four 10-day experimental periods, 10 participants wore intra-oral removable acrylic palatal expanders with four human enamel slabs with preformed lesions (B1 and B2): CO1 and CO2-Control: silica dentifrice without fluoride; MP1 and MP2: MI Paste; MPP1 and MPP2: MI Paste Plus; and FD1 and FD2: Fluoride dentifrice. The Knoop hardness test (50/15s Micromet 2001, Buehler) was performed after demineralization (B1 and B2) and after treatment (T1 and T2).

Results: SH was higher in all treatment groups, when compared with the controls, except for CO2 (Mann-Whitney Wilcoxon Test; p < 0.05). The %SH was similar between MPP2 and FD2 and between MPP2 and MP2; however, FD2 and MPP2 products were more effective in microhardness recovery. In B1, all treatment groups were similar.

Conclusion: MPP and FD are more effective in preventing demineralization in enamel subsurface lesions.

Keywords: demineralization; dental enamel; sodium fluoride; tooth remineralization; toothpastes.

MeSH terms

  • Carbon Dioxide
  • Cariostatic Agents / pharmacology
  • Cariostatic Agents / therapeutic use
  • Caseins / pharmacology
  • Caseins / therapeutic use
  • Dentifrices* / therapeutic use
  • Fluorides / therapeutic use
  • Humans
  • Phosphopeptides
  • Silicon Dioxide
  • Tooth Demineralization* / drug therapy
  • Tooth Demineralization* / prevention & control
  • Tooth Remineralization

Substances

  • casein phosphopeptide-amorphous calcium phosphate nanocomplex
  • Caseins
  • Fluorides
  • Cariostatic Agents
  • Dentifrices
  • Phosphopeptides
  • Carbon Dioxide
  • Silicon Dioxide