title: Remineralization of enamel subsurface lesions in situ by sugar-free lozenges containing casein phosphopeptide-amorphous 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.
  
  
  CONCLUSIONS
  This study demonstrates that lozenges are a suitable vehicle for the delivery of CPP-ACP to promote enamel remineralization.
authors.affiliation: School of Dental Science, The University of Melbourne, Victoria.
authors.forename: F
authors.initials: F
authors.lastname: Cai
authors.forename: P
authors.initials: P
authors.lastname: Shen
authors.forename: M V
authors.initials: MV
authors.lastname: Morgan
authors.forename: E C
authors.initials: EC
authors.lastname: Reynolds
mesh_terms: D000278:Administration, Buccal; D000328:Adult; D000704:Analysis of Variance; D002130:Calcium Phosphates / Q000008:administration & dosage*; D002327:Cariostatic Agents / Q000008:administration & dosage*; D002364:Caseins / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003720:Densitometry; D003743:Dental Enamel / Q000187:drug effects; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008852:Microradiography; D014677:Pharmaceutical Vehicles; D013549:Sweetening Agents; D014089:Tooth Remineralization / Q000379:methods*
chemical_list: D002130:Calcium Phosphates; D002327:Cariostatic Agents; D002364:Caseins; D004338:Drug Combinations; D014677:Pharmaceutical Vehicles; D013549:Sweetening Agents; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex