Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate

• Published in: Clinical oral investigations Vol. 15; no. 3; pp. 369 - 373
• Main Authors: Bröchner, Ann, Christensen, Carsten, Kristensen, Bjarne, Tranæus, Sofia, Karlsson, Lena, Sonnesen, Liselotte, Twetman, Svante
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.06.2011; Springer Nature B.V
• Subjects: Adolescent; Analysis of Variance; Cariostatic Agents - therapeutic use; Caseins - therapeutic use; Chi-Square Distribution; Dental Caries - drug therapy; Dental Caries - etiology; Dental Caries Activity Tests; Dentistry; Female; Fluorescence; Humans; Light; Male; Medicine; Original Article; Orthodontic Brackets - adverse effects; Prospective Studies; Radiography, Dental, Digital; Reproducibility of Results; Single-Blind Method; Tooth Remineralization - methods; Treatment Outcome; Casein derivate; Remineralisation; Adolescents; Orthodontics; Fixed appliances
• ISSN: 1432-6981; 1436-3771; 1436-3771
• DOI: 10.1007/s00784-010-0401-2

This study aims to investigate the effect of topical applications of 10% casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) on white spot lesions (WSL) detected after treatment with fixed orthodontic appliances. Sixty healthy adolescents with ≥1 clinically visible WSL at debonding were recruited and randomly allocated to a randomised controlled trial with two parallel groups. The intervention group was instructed to topically apply a CPP–ACP -containing agent (Tooth Mousse, GC Europe) once daily and the subjects of the control group brushed their teeth with standard fluoride toothpaste. The intervention period was 4 weeks and the endpoints were quantitative light-induced fluorescence (QLF) on buccal surfaces of the upper incisors, cuspids and first premolars and visual scoring from digital photos. The attrition rate was 15%, mostly due to technical errors, and 327 lesions were included in the final evaluation. A statistically significant ( p  < 0.05) regression of the WSL was disclosed in both study groups compared to baseline, but there was no difference between the groups. The mean area of the lesions decreased by 58% in the CPP–ACP group and 26% in the fluoride group ( p  = 0.06). The QLF findings were largely reflected by the clinical scores. No side effects were reported. Topical treatment of white spot lesions after debonding of orthodontic appliances with a casein phosphopeptide-stabilised amorphous calcium phosphate agent resulted in significantly reduced fluorescence and a reduced area of the lesions after 4 weeks as assessed by QLF. The improvement was however not superior to the “natural” regression following daily use of fluoride toothpaste.