Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate.
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.
Bröchner
Ann
A
Department of Orthodontics, Odense Central Clinic, Tandplejen Grønløkkevej 30, DK-5000 Odense C, Denmark.
Christensen
Carsten
C
Kristensen
Bjarne
B
Tranæus
Sofia
S
Karlsson
Lena
L
Sonnesen
Liselotte
L
Twetman
Svante
S
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
D002327:Cariostatic Agents; D002364:Caseins; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex
Caries Res. 2007;41(6):455-9
17827963
Angle Orthod. 2009 Jan;79(1):64-9
19123708
J Clin Orthod. 2003 Jan;37(1):19-21
12621744
Int J Paediatr Dent. 2008 Jul;18(4):284-90
18435723
Eur J Oral Sci. 2001 Apr;109(2):71-5
11347658
Caries Res. 2004 Sep-Oct;38(5):413-20
15316184
Am J Orthod. 1982 Feb;81(2):93-8
6758594
Aust Dent J. 2008 Sep;53(3):268-73
18782374
J Am Dent Assoc. 2008 Jul;139(7):915-24; quiz 994-5
18594077
Eur J Orthod. 2003 Jun;25(3):217-23
12831210
Cochrane Database Syst Rev. 2004;(3):CD003809
15266503
Oral Health Prev Dent. 2007;5(3):229-33
17977295
Eur J Dent. 2009 Apr;3(2):127-34
19421393
Acta Odontol Scand. 2004 Dec;62(6):313-8
15848974
J Dent Res. 2009 Dec;88(12):1148-53
19887683
Am J Orthod Dentofacial Orthop. 2007 Jun;131(6):705.e1-9
17561043
J Dent Res. 2008 Apr;87(4):344-8
18362316
Acta Odontol Scand. 2007 Oct;65(5):284-91
17851827
Acta Odontol Scand. 2003 Dec;61(6):347-55
14960006