title: Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate.
abstract: This study aims to investigate the effect of topical applications of 10% casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSL) detected after treatment with fixed orthodontic appliances. Sixty healthy adolescents with ≥1 clinically visible WSL at debonding were recruited and randomly allocated to a randomised controlled trial with two parallel groups. The intervention group was instructed to topically apply a CPP-ACP -containing agent (Tooth Mousse, GC Europe) once daily and the subjects of the control group brushed their teeth with standard fluoride toothpaste. The intervention period was 4 weeks and the endpoints were quantitative light-induced fluorescence (QLF) on buccal surfaces of the upper incisors, cuspids and first premolars and visual scoring from digital photos. The attrition rate was 15%, mostly due to technical errors, and 327 lesions were included in the final evaluation. A statistically significant (p < 0.05) regression of the WSL was disclosed in both study groups compared to baseline, but there was no difference between the groups. The mean area of the lesions decreased by 58% in the CPP-ACP group and 26% in the fluoride group (p = 0.06). The QLF findings were largely reflected by the clinical scores. No side effects were reported. Topical treatment of white spot lesions after debonding of orthodontic appliances with a casein phosphopeptide-stabilised amorphous calcium phosphate agent resulted in significantly reduced fluorescence and a reduced area of the lesions after 4 weeks as assessed by QLF. The improvement was however not superior to the "natural" regression following daily use of fluoride toothpaste.
authors.affiliation: Department of Orthodontics, Odense Central Clinic, Tandplejen Grønløkkevej 30, DK-5000 Odense C, Denmark.
authors.forename: Ann
authors.initials: A
authors.lastname: Bröchner
authors.forename: Carsten
authors.initials: C
authors.lastname: Christensen
authors.forename: Bjarne
authors.initials: B
authors.lastname: Kristensen
authors.forename: Sofia
authors.initials: S
authors.lastname: Tranæus
authors.forename: Lena
authors.initials: L
authors.lastname: Karlsson
authors.forename: Liselotte
authors.initials: L
authors.lastname: Sonnesen
authors.forename: Svante
authors.initials: S
authors.lastname: Twetman
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002364:Caseins / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003731:Dental Caries / Q000188:drug therapy* / Q000209:etiology; D003732:Dental Caries Activity Tests; D005260:Female; D005453:Fluorescence; D006801:Humans; D008027:Light; D008297:Male; D016910:Orthodontic Brackets / Q000009:adverse effects*; D011446:Prospective Studies; D019252:Radiography, Dental, Digital; D015203:Reproducibility of Results; D016037:Single-Blind Method; D014089:Tooth Remineralization / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex
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