title: Effect of a dental cream containing amorphous cream phosphate complexes on white spot lesion regression assessed by laser fluorescence.
abstract: OBJECTIVE
  To investigate and compare the effects of a dental cream containing complexes of casein phosphoprotein-amorphous calcium phosphate (CPP-ACP) and fluoride mouthwashes on the regression of white spot lesions (WSL).
  
  
  METHODS
  The study group consisted of 26 healthy adolescents (mean age 14.6 years) exhibiting 60 teeth with 152 visible WSL sites on incisors and canines immediately after debonding of fixed orthodontic appliances. After bracket removal, professional tooth cleaning and drying, a visual scoring (0-4) and laser fluorescence (LF) readings were carried out. The patients were randomly assigned to two different treatment protocols with the aim of remineralising the lesions: A) daily topical applications of a dental cream containing CPP-ACP (Topacal) for 3 months followed by a 3-month period of daily toothbrushing with fluoridated dentifrice, or B) daily 0.05% sodium fluoride mouthwash combined with fluoridated dentifrice for 6 months. The registrations were repeated after 1, 3, 6 and 12 months and follow-up data were compared with baseline with aid of chi-square and paired t-tests.
  
  
  RESULTS
  A significant improvement of the clinical WSL-scores was found over time in both groups, but there was a statistically significant difference (p < 0.01) concerning the number of sites that totally disappeared after 12 months in favour of the CPP-ACP regime, 63% compared with 25% respectively. The clinical registrations were mirrored by a statistically significant decrease (p < 0.05) in the LF readings at the 6- and 12-month follow-ups compared with baseline. No significant differences were displayed between the groups.
  
  
  CONCLUSIONS
  Clinical scoring and LF assessment suggested that both regimens could promote regression of WSL after debonding of fixed orthodontic appliances. The visual evaluation suggested an aesthetically more favourable outcome of the amorphous calcium phosphate treatments.
authors.affiliation: Department of Orthodontics, Public Dental Service, Skansgatan 1B, SE-302 46 Halmstad, Sweden.
authors.forename: Anita
authors.initials: A
authors.lastname: Andersson
authors.forename: Kerstin
authors.initials: K
authors.lastname: Sköld-Larsson
authors.forename: Anders
authors.initials: A
authors.lastname: Hallgren
authors.forename: Lars G
authors.initials: LG
authors.lastname: Petersson
authors.forename: Svante
authors.initials: S
authors.lastname: Twetman
mesh_terms: D000293:Adolescent; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D002364:Caseins / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D003731:Dental Caries / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003732:Dental Caries Activity Tests; D003802:Dentifrices / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D005453:Fluorescence; D006801:Humans; D007834:Lasers; D008297:Male; D009067:Mouthwashes / Q000737:chemistry / Q000627:therapeutic use; D016910:Orthodontic Brackets / Q000009:adverse effects; D016037:Single-Blind Method; D012969:Sodium Fluoride / Q000008:administration & dosage / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D014089:Tooth Remineralization / Q000379:methods*
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; D003802:Dentifrices; D009067:Mouthwashes; C522642:topacal C-5; D012969:Sodium Fluoride