title: Remineralization effect of CPP-ACP and fluoride for white spot lesions in vitro.
abstract: OBJECTIVE
  This in vitro study compared the remineralization effect on white spot lesions of casein phosphopeptide-amorphous calcium phosphate crème, or CPP-ACP (MI Paste™), 1.1% NaF dentifrice containing 5000ppm of fluoride (ControlRX™), or CPP-ACP crème with 900ppm of fluoride (MI Paste Plus™) with that of a control.
  
  
  METHODS
  Artificial white spot lesions were created on smooth enamel surfaces of sound molars using a previously reported demineralization model. Specimens were randomly assigned to four treatments (n=35) with a pH-cycling model over 30 days: Control (no treatment); MI Paste (10% CPP-ACP crème); F5000 (1.1% NaF dentifrice); or MI Paste Plus (10% CPP-ACP plus 900ppm fluoride crème). Products were applied following manufacturers' directions. Changes in mean lesion depth expressed by percent fluorescence loss (ΔF%), and lesion area (mm(2)) from baseline to after treatment were measured with light-induced fluorescence (QLF). Mean values of each parameter were compared between groups (p<0.05).
  
  
  RESULTS
  The remineralization pattern for the F5000 group was unique with marked initial remineralization during the first 10 days and little subsequent change. Based on mean lesion area, the F5000 demonstrated greater remineralization than Control, MI Paste and MI Paste Plus groups. Based on mean fluorescence loss, the F5000 group showed improved remineralization relative to MI Paste Plus, but did not differ statistically from the Control at the end of 30 days.
  
  
  CONCLUSIONS
  The 1.1% NaF dentifrice demonstrated overall greater remineralization ability than 10% CPP-ACP crème. However, the 1.1% NaF dentifrice was only as effective as the Control to reduce fluorescence loss.
  
  
  CONCLUSIONS
  This study showed that a 1.1% NaF dentifrice (5000ppm) demonstrated greater remineralization ability than the CPP-ACP topical tooth crème and that the addition of fluoride to its formulation seems to enhance remineralization. Saliva also has the ability to exert an important remineralization effect over time.
authors.affiliation: University of Louisville, United States. Electronic address: gmoliv03@louisville.edu.
authors.forename: Gustavo M S
authors.initials: GM
authors.lastname: Oliveira
authors.affiliation: University of North Carolina at Chapel Hill, United States.
authors.forename: André V
authors.initials: AV
authors.lastname: Ritter
authors.affiliation: University of North Carolina at Chapel Hill, United States.
authors.forename: Harald O
authors.initials: HO
authors.lastname: Heymann
authors.affiliation: University of North Carolina at Chapel Hill, United States.
authors.forename: Edward
authors.initials: E
authors.lastname: Swift
authors.affiliation: University of North Carolina at Chapel Hill, United States.
authors.forename: Terry
authors.initials: T
authors.lastname: Donovan
authors.affiliation: University of Louisville, United States.
authors.forename: Guy
authors.initials: G
authors.lastname: Brock
authors.affiliation: University of North Carolina at Chapel Hill, United States.
authors.forename: Tim
authors.initials: T
authors.lastname: Wright
mesh_terms: D002327:Cariostatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002364:Caseins / Q000008:administration & dosage / Q000627:therapeutic use*; D003731:Dental Caries / Q000188:drug therapy* / Q000473:pathology; D003743:Dental Enamel / Q000187:drug effects / Q000473:pathology; D003802:Dentifrices / Q000627:therapeutic use; D004338:Drug Combinations; D005453:Fluorescence; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008422:Materials Testing; D011897:Random Allocation; D012969:Sodium Fluoride / Q000008:administration & dosage / Q000627:therapeutic use; D014089:Tooth Remineralization / Q000379:methods*
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; D003802:Dentifrices; D004338:Drug Combinations; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D012969:Sodium Fluoride
keywords: CPP-ACP; Fluoride; QLF; Remineralization; White spot lesions