Casein-phosphopeptide-amorphous-calcium-phosphate plus brushing with fluoride toothpaste for remineralization of early caries

BACKGROUND: Casein-Phosphopeptide of Amorphous-Calcium-Phosphate (CPP-ACP) promotes dental remineralization and revers of early carious lesion; however, the clinical evidence is limited. OBJECTIVE: Compare the preventive and remineralizing effect of CPP-ACP in two presentations: chewing gum and cream for self-application on permanent teeth. MATERIALS AND METHODS: Clinical trial carried out in students aged 11 to 13 years, with a duration of three months. Permanent premolar and molar surfaces were included: free of caries and with incipient carious lesions. Participants were randomly assigned to three groups: a) Chewing gum with CPP-ACP; b) Self-apply cream with CPP-ACP and, c) control. They brushed their teeth with a sodium fluoride toothpaste. For data analysis, median and percentile were calculated and Kruskal-Wallis, Mann-Whitney U and Wilcoxon tests were used. RESULTS: Ninety students aged 11 to 13 years were studied for three months. A total of 971 permanent premolar and molar surfaces were included: 843 caries-free and 128 with incipient carious lesions. A decrease in fluorescence values was found. The medians of the differences between the baseline value and after each treatment in teeth without caries were: chewing gum:-2 (-5.0)); cream group:-1 (-3.1) and control group:-1 (-3.1). p = 0.001. For those teeth with incipient lesions, the medians were: gum:-15 (-19,-2), cream:-10 (-14,-5) and control-10 (-16,-4) with significant differences between the gum group with that of pasta and control (p = 0.001). CONCLUSION: CPP-ACP plus brushing with fluoridated-toothpaste showed remineralizing effect and limited the advancement of incipient carious lesions, with greater efficacy for chewing gum.