title: In vitro evaluation of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) effect on stripped enamel surfaces. A SEM investigation.
abstract: OBJECTIVE
  Interproximal enamel reduction (orthodontic stripping) leaves surface-roughness that encourages plaque adherence. Sealants and fluoride products have been recommended to avoid possible detrimental effects. The objective of this study was to qualitatively evaluate, by means of scanning electron microscopy (SEM), the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on stripped enamel morphology after exposure to an acid solution.
  
  
  METHODS
  15 extracted lower incisors underwent stripping with metal strips (Horico, 80 microm) by 1 operator. Mesial and distal surfaces were sectioned into 30 samples (22 stripped; 8 unstripped) and assigned to 2 groups: Group A (2 stripped; 2 unstripped) served as control; in Group B (20 stripped; 6 unstripped) tooth mousse containing CPP-ACP was tested. For 8 days, teeth were placed in acid lactic solution for 2h three times a day (from 9a.m. to 9p.m.) with 2h water preservation in between. After each demineralizing bath, samples of group B were coated with CPP-ACP for 5 min before immersion into water.
  
  
  RESULTS
  In Group A, stripped samples exhibited greater demineralization compared to unstripped. In Group B, CPP-ACP reduced enamel dissolution on both intact and abraded samples compared to Group A.
  
  
  CONCLUSIONS
  Injuries to enamel morphology caused by stripping might predispose to greater demineralization in the event of exposure to acid environment. Topical applications of CPP-ACP could be effective in promoting enamel remineralization after interdental stripping.
authors.affiliation: Department of Orthodontics, Alma Mater Studiorum University of Bologna, Bologna, Italy. giulio.alessandri@unibo.it
authors.forename: Alessandri Bonetti
authors.initials: AB
authors.lastname: Giulio
authors.forename: Zanarini
authors.initials: Z
authors.lastname: Matteo
authors.forename: Incerti Parenti
authors.initials: IP
authors.lastname: Serena
authors.forename: Marchionni
authors.initials: M
authors.lastname: Silvia
authors.forename: Checchi
authors.initials: C
authors.lastname: Luigi
mesh_terms: D002327:Cariostatic Agents / Q000627:therapeutic use*; D002364:Caseins / Q000627:therapeutic use*; D003743:Dental Enamel / Q000601:surgery* / Q000648:ultrastructure; D006801:Humans; D007180:Incisor; D008855:Microscopy, Electron, Scanning; D017001:Tooth Demineralization / Q000517:prevention & control*; D014089:Tooth Remineralization / Q000379:methods*
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex