Advances in enamel remineralization: Casein phosphopeptide-amorphous calcium phosphate

Casein phosphopeptides (CPP) are multi-phosphorylated peptides from an enzymatic digest of the bovine milk protein casein. These peptides have a remarkable ability to stabilize calcium phosphate in solution as amorphous calcium phosphate (ACP). Through their multiple phosphoseryl residues, the CPP bind to forming nanoclusters of ACP in metastable solution, preventing their growth to the critical size required for nucleation and phase transformations. The casein phosphopeptide-amorphous calcium phosphate (CPP-ACP: Recaldent(TM)) nano clusters have been shown to localize at the tooth surface and prevent caries in laboratory, animal and human in situ caries models. The CPP-ACP have also been shown to remineralize enamel subsurface lesions in vitro and in situ when delivered in a sugar-free chewing gum. The proposed anticariogenic mechanism for CPP-ACP is the localization of ACP at the tooth surface which buffers the free calcium and phosphate ion activities, thereby helping to maintain a state of supersaturation with respect to tooth enamel, depressing demineralization and enhancing remineralization. The CPP-ACP have potential as an additive to foods and oral care products for the control of dental caries.