Effect of Fluoride Varnish Containing CPP-ACP on Preventing Enamel Erosion

This study aimed to investigate the effect of a fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate treatment on the prevention of enamel erosion, and it compared the results with those of other fluoride varnishes. Fifty enamel specimens obtained from bovine incisors were randomly divided into five groups (n=10) based on the type of surface pretreatment used: intact enamel (Group 1); intact enamel+erosive cycles (Group 2); intact enamel+MI varnish+erosive cycles (Group 3); intact enamel+Clinpro White varnish+erosive cycles (Group 4); and intact enamel+Duraphat varnish+erosive cycles (Group 5). The specimens were subjected to erosive cycles for five days. The surface roughness was evaluated using atomic force microscopy. The results were statistically analyzed using one-way ANOVA and Tukey’s tests. Group 1 had the smoothest surfaces. After the erosive cycles, the greatest surface roughness values were observed in Group 2, followed by Groups 5, 4, and 3, respectively. Statistically significant differences were observed among all groups (p<0.05). The application of fluoride varnishes had some positive effects on preventing enamel erosion; however, the most effective agent was fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate.

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Reversal of Root Caries with Casein Phosphopeptide-Amorphous Calcium Phosphate and Fluoride Varnish in Xerostomia

Caries Research ◽

10.1159/000516176 ◽

2021 ◽

pp. 1-10

Author(s):

Ahmed Sleibi ◽

Anwar R. Tappuni ◽

Aylin Baysan

Keyword(s):

Calcium Phosphate ◽

Amorphous Calcium Phosphate ◽

Primary Root ◽

Severity Index ◽

Salivary Flow ◽

Root Caries ◽

Carious Lesions ◽

Group 2 ◽

Casein Phosphopeptide ◽

Group 1

Different formulas of topical fluoride have been used to manage root carious lesions. This clinical trial aimed to investigate the efficacy of a dental varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride compared with fluoride alone in reversing/arresting root caries in xerostomic patients over 1 year. A total of 80 patients (age range 45–92 years) with primary root caries (n = 184 root carious lesions) and unstimulated salivary flow rate of <0.2 mL/min were randomly allocated to receive either dental varnish containing CPP-ACP and 5% fluoride (group 1: MI varnish; GC, Japan) (n = 41, 83 lesions), or dental varnish with 5% fluoride alone (group 2: NUPRO White; Dentsply, USA) (n = 39, 101 lesions). Clinical assessments with Severity Index (SI) for root caries, DIAGNOdent measurements, and varnish application were carried out at baseline, 3, 6, and 12 months. Standard oral hygiene instructions with 1,450 ppm fluoride toothpastes were provided for both groups. After 3 months, 63.9% (n = 46) of root caries in group 1 became hard (SI: 0) compared with 39.3% (n = 35) in group 2 (p < 0.01). After 6 and 12 months, the differences in SI were insignificant (group 1, n = 60, 83.3%) (group 2, n = 66, 74.2%) (p = 0.36), and (group 1, n = 60, 89.6%) (group 2, n = 67, 81.7%, n = 1 soft, 1.2%) (p = 0.29), respectively. In both groups, noncavitated leathery lesions were more likely to become hard when compared to the cavitated root caries. A significant decrease in plaque index, surface roughness, lesion dimension, and DIAGNOdent readings with a significant increase in lesion distance from the gingival margin was reported in both groups (p < 0.05). This study has provided evidence that fluoride dental varnish either with or without calcium and phosphate has the potential to arrest/reverse root caries, especially noncavitated lesions for patients with xerostomia.

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Comparison of Casein Phosphopeptide with Potassium Nitrate and Sodium Monofluorophosphate Desensitizing Efficacy after In-Office Vital Bleaching—A Randomized Trial

Applied Sciences ◽

10.3390/app11199291 ◽

2021 ◽

Vol 11 (19) ◽

pp. 9291

Author(s):

Hafiz Muhammad Adil ◽

Rizwan Jouhar ◽

Muhammad Adeel Ahmed ◽

Sakeenabi Basha ◽

Naseer Ahmed ◽

...

Keyword(s):

Calcium Phosphate ◽

Amorphous Calcium Phosphate ◽

Potassium Nitrate ◽

Anterior Teeth ◽

Significant Difference ◽

Desensitizing Agents ◽

Group 3 ◽

Group 2 ◽

Casein Phosphopeptide ◽

Group 1

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), potassium nitrate, and sodium monofluorophosphate are desensitizing agents that help in reducing teeth sensitivity. However, indecisive evidence exists regarding their efficacy. Therefore, this study was conducted to compare the desensitizing efficacy of casein phosphopeptide-amorphous calcium phosphate and potassium nitrate with sodium monofluorophosphate agents after in-office vital bleaching. A randomized controlled trial was conducted on 2011 patients. The patients were randomly and equally divided into the CPP-ACP group (group 1), potassium nitrate with sodium monofluorophosphate group (group 2), and placebo gel (group 3). The upper and lower anterior teeth including the first premolar were isolated with a rubber dam, then the bleaching agents were applied on the labial surface of all the teeth, followed by light activation for 15 min. The procedure was repeated 3 times with an interval of 5 min in-between. After carrying out the bleaching procedure, patients were given a desensitizing gel or placebo gel in unmarked syringes with an instruction to apply it every 12 h for up to 3 days. The intensity of pain was recorded using a discomfort interval scale (DIS). A decrease in pain was observed 24 h after the application of the desensitizing gel in groups 1 and 2. However, in group 3, the pain persisted, with 46 (69.69%) patients having moderate pain and 14 (21.21%) developing severe pain over time. A significant difference in discomfort level with time was noted in group 1 (p = 0.015) and group 2 (p = 0.036). However, no significant difference was found in group 3 (p = 0.085). It was concluded that both desensitizing agents performed exceptionally well in reducing teeth sensitivity.

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Effects of Amorphous Calcium Phosphate Administration on Dental Sensitivity during In-Office and At-Home Interventions

Dentistry Journal ◽

10.3390/dj6040052 ◽

2018 ◽

Vol 6 (4) ◽

pp. 52 ◽

Cited By ~ 2

Author(s):

Giacomo Oldoini ◽

Antonino Bruno ◽

Anna Genovesi ◽

Luca Parisi

Keyword(s):

Hydrogen Peroxide ◽

Calcium Phosphate ◽

Amorphous Calcium Phosphate ◽

Potassium Fluoride ◽

Tooth Bleaching ◽

Carbamide Peroxide ◽

Casein Phosphopeptides ◽

Group 2 ◽

Group 1 ◽

At Home

Background. Tooth bleaching is the most frequently employed whitening procedure in clinics. The major side effect of tooth bleaching is dental sensitivity during and after the treatment. Here, we evaluated whether the administration of amorphous calcium phosphate (ACP), during in-office and at-home procedures may impact on dental sensitivity. Methods. Eighty patients, responding to the study requirements were enrolled according to the following criteria. Group 1 (n = 40), received in-office, 10% ACP prior to 30% professional hydrogen peroxide application. The whitening procedure continued at home using 10% carbamide peroxide with 15% ACP for 15 days. Group 2 (n = 40) received only 30% hydrogen peroxide application and continued the whitening procedures at home, using 10% carbamide hydroxide, without ACP- Casein phosphopeptides (CPP), for 15 days. Dental sensitivity was recorded with a visual analogue scale (VAS) at baseline, immediately after, and at 15 days after treatment in the two groups. Results. We observed that patients receiving ACP in the bleaching mixture experienced decreased dental sensitivity (* p ≤ 0.05), as detected by VAS scale analysis immediately following the procedures. Patients receiving ACP-CPP during at-home procedures showed a statistically significant (*** p ≤ 0.0001) reduction of dental sensitivity. Conclusions. We demonstrated that ACP-CPP administration, while exerting the same whitening effects as in control subjects receiving potassium fluoride (PF), had an impact on the reduction of dental sensitivity, improving patient compliance.

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