Title Desensitizing Products Containing CPP-ACP Have a More Sustained but Slower Effect Than Products Containing Potassium Nitrate
Clinical Question In patients with dentin hypersensitivity, are products containing Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) more effective in reducing the symptoms of sensitivity as compared to those containing potassium nitrate?
Clinical Bottom Line Desensitizing products containing CPP-ACP have a more sustained but slower effect than products containing potassium nitrate. This is supported by a randomized controlled trial of 102 subjects where significant decrease in dentin hypersensitivity was demonstrated with both treatment groups as compared to the placebo groups.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
25028689Mahesuti/2014102 adults with at least two hypersensitive teethRandomized Controlled Trial
Key resultsMultivariate analysis showed that the potassium nitrate group (UltraEZ), had a significant decrease in the Visual Analogue Scale (VAS) scores of dentin hypersensitivity as compared to placebo at day 2, day 7 and day 14 of treatment (P=0.000). The CPP-ACP group (MI paste) had a significant decrease of VAS score at day 7 and day 14. At 30 days post treatment, both groups’ scores were significantly lower than baseline, but the UltraEZ group did not have a significant decrease in VAS score as compared to day 14, while the MI Paste group did. Placebo groups showed a small improvement in VAS scores at day 14 but returned to baseline values by day 30.
Evidence Search "Caseins"[Mesh] AND "Dentin Sensitivity"[Mesh]
Comments on
The Evidence
Validity: The treatment groups and the placebo groups were similar at the start, were treated the same in the experiment, and all 102 subjects had adequate follow up and acceptable compliance. Recall bias was unlikely and the experimenters did not disclose any competing interests. The completion rate was >80% of the participants and there was double blinding of the subjects and the evaluators. Perspective: The RCT was well designed as a “placebo-controlled, randomized, double-blinded, and parallel-group” study. It was a reasonable short-term approach of treatment of dentin hypersensitivity, but a long- term approach should also be investigated. Tactile sensitivity was measured through the use of a probe. The study did not investigate sensitivity to cold or air blasts, which are common triggers for hypersensitivity.
Applicability As dentin hypersensitivity is a common complaint of the general dental practice, the evidence shows that the clinician can recommend either products containing potassium nitrate or CPP-ACP for treatment and relief. The demographics of the study, age from 18 to 70 years, are representative of the patient group in a general practice. However, as the desensitizing agents were delivered in custom trays twice a day, this application might decrease compliance of the average patient. More studies on the treatment period to produce the best efficacy is needed.
Specialty (General Dentistry) (Orthodontics) (Restorative Dentistry)
Keywords CPP-ACP, Casein Phosphopeptide- Amorphous Calcium Phosphate, KNO3, potassium nitrate, dentin hypersensitivity
ID# 3061
Date of submission 03/15/2016
E-mail zhenga@livemail.uthscsa.edu
Author Annie Zheng
Co-author(s) e-mail
Faculty mentor Kelly C. Lemke, DDS
Faculty mentor e-mail LemkeK@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?)
None available
Comments and Evidence-Based Updates on the CAT
None available