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| Title |
Efficacy of Casein Phosphopeptide-Amorphous Calcium Phosphate(CPP-ACP)in Remineralizing Demineralized Tooth Structure |
| Clinical Question |
In a patient with dental caries, is casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) effective in remineralizing demineralized tooth structure as compared to no treatment? |
| Clinical Bottom Line |
CPP-ACP demonstrates some remineralization of demineralized tooth structure, but more evidence is needed to make a strong recommendation of CPP-ACP for the reminerlization of demineralized teeth. (See Comments on the CAT below) |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 18594077 | Azarpazhooh/2008 | 6 studies of in situ caries models in adult patients. | Systematic Review | | Key results | Of the studies identified by the systematic review, only 1 study compared a product (lozenges) with CPP-ACP to no treatment, and found it to be effective in promoting dose-dependent enamel remineralization. Four of the identified studies compared gum with CPP-ACP to gum without CPP-ACP, and three found greater remineralization in the group with CPP-ACP. One the identified studies compared milk with CPP-ACP to milk without CPP-ACP and found an improvement in subsurface remineralization in the group with CPP-ACP. | |
| Evidence Search |
Meta-Analysis, "Dental Caries"[Mesh] "casein phosphopeptide-amorphous calcium phosphate nanocomplex "[Substance Name] |
Comments on
The Evidence |
A systematic review containing a comprehensive, detailed search for relevant trials (which were each assessed for validity) produced only one study comparing treatment with CPP-ACP to no treatment. This alone is not enough evidence to support the efficacy of CPP-ACP. However, three studies finding chewing gum with CPP-ACP to be more effective than gum without CPP-ACP and 1 study comparing milk with CPP-ACP against milk without CPP-ACP add to the evidence supporting the effectiveness of CPP-ACP in remineralizing tooth structure. |
| Applicability |
The current evidence does not warrant a recommendation of CPP-ACP to the average patient. However, a practitioner might consider recommending chewing gum with CPP-ACP to patients who are gum chewers and have a high caries risk. |
| Specialty/Discipline |
(Public Health) (General Dentistry) (Orthodontics) (Restorative Dentistry) |
| Keywords |
CPP-ACP; calcium phosphopeptide-amorphous calcium phosphate; dental caries; remineralization
|
| ID# |
573 |
| Date of submission: |
03/31/2010 |
| E-mail |
bonnerj@livemail.uthscsa.edu |
| Author |
Justin Bonner |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
James B. Summitt, DDS, MS |
| Faculty mentor/Co-author e-mail |
SUMMITT@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Matthew Nondorf (Valparaiso, IN) on 08/09/2011
Was the re-minerilization noted at the marcoscopic clinical level or the microscopic level? I think most practicing dentists are interested in results the patient and dentist can appreciate. | |
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