title: Remineralizing efficacy of a CPP-ACP cream on enamel caries lesions in situ.
abstract: The aim of this double-blind, randomized, cross-over in situ study was to compare the remineralizing effects induced by the application of casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP)-containing cream (without fluoride) after the use of fluoride toothpaste with the prolonged use of fluoride toothpaste on enamel caries lesions in situ. During each of three experimental legs of 4 weeks, 13 participants wore intra-oral mandibular appliances with 8 pre-demineralized bovine enamel specimens in the vestibular flanges mimicking either 'easily cleanable' or 'proximal' surfaces (n = 312). The three randomly allocated treatments were as follows: (1) application of CPP-ACP-containing cream (GC Tooth Mouse, non-fluoride) after the use of fluoride toothpaste (1,400 ppm NaF; TM), (2) prolonged application of fluoride toothpaste (1,400 ppm NaF; positive control, PC) and (3) prolonged application of fluoride-free toothpaste (negative control, NC). Additionally, one of each of the two flanges was brushed twice daily with the respective toothpaste. The differences in integrated mineral loss as assessed by transversal microradiography were calculated between values before and after the in situ period. Changes in mineral loss were analysed for those pairs of subgroups differing in only one of the three factors (intervention, brushing and position). The PC treatment induced a significantly higher mineral gain compared with the TM and NC treatments. No significant differences between TM and NC for both positions were observed. In conclusion, the additional use of a CPP-ACP-containing cream seems to be less efficacious in remineralizing caries lesions than the prolonged application of fluoride toothpaste.
authors.affiliation: Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Meyer-Lueckel
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wierichs
authors.forename: Timo
authors.initials: T
authors.lastname: Schellwien
authors.forename: Sebastian
authors.initials: S
authors.lastname: Paris
mesh_terms: D000328:Adult; D000818:Animals; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002364:Caseins / Q000627:therapeutic use*; D002417:Cattle; D018592:Cross-Over Studies; D003731:Dental Caries / Q000473:pathology / Q000517:prevention & control*; D003743:Dental Enamel / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008852:Microradiography / Q000379:methods; D008875:Middle Aged; D012969:Sodium Fluoride / Q000627:therapeutic use; D014089:Tooth Remineralization / Q000379:methods*; D014099:Toothbrushing / Q000295:instrumentation; D014100:Toothpastes / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; D014100:Toothpastes; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D012969:Sodium Fluoride