n Journal of Minimum Intervention in Dentistry - Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) - a systematic review [poster] : grey literature




[This document has been captured as part of the JMID-section for Grey-literature. Grey (or gray) literature refers to informally published written material that may be difficult to trace via conventional databases and/or journals as it is not formally published or is not widely accessible. However, Grey literature may still be an important source of information. Examples of grey literature include e.g: patents, reports, working documents or unpublished manuscripts]

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is a casein derived peptide, with added calcium and phosphate, which acts as a calcium and phosphate reservoir when incorporated into dental plaque and on the tooth surface.The CPP-ACP nano complexes release calcium and phosphate ions via a pH or concentration gradient mechanism to maintain a supersaturated environment with respect to hydroxyapatite, therefore reducing demineralization and enhancing remineralization. Casein Phosphopeptide Amorphous Calcium Phosphate (CPP-ACP) nanocomplexes have been demonstrated to have anticariogenic potential in laboratory, animal, and human in situ experiments. The ability of CPP-ACP to remineralise white spot lesions of enamel both in vitro and in situ has been widely reported. In a recent randomized clinical trial, CPP-ACP incorporated to either sorbitol- or xylitol-based gum resulted in a dose-related increase in enamel remineralization, with 0.19, 10.0, 18.8, and 56.4mg of CPP-ACP producing an increase in enamel remineralization of 9, 63, 102 and 152% respectively, relative to the control gum, independent of gum weight or type. In other studies, the addition of low concentrations (<1.0%) of CPP-ACP to acidic sports drink has been shown to reduce erosive potential without significantly altering taste. The inclusion of fluoride into CPP-ACP (known as CPP-ACFP) forms a novel material with fluoride incorporated into the nano-complex. Clinically, CPP-ACP can be delivered to the tooth surface in several vehicles: chewing gum, lozenge, topical crème, mouthrinse, toothpaste and added to glass ionomer cement (GIC) restorative material. This systematic review forms part of comprehensive review project with the focus on the current evidence base for the concept of minimal intervention (MI) dentistry. MI is a philosophy of professional care, concerned with the risk, earliest detection and earliest possible treatment of disease on micro (molecular) levels, followed by the most minimally invasive and patient-friendly options to repair irreversible damage caused by such disease. This systematic review sought to critically evaluate the evidence for CPP-ACP supplements in terms of its ability to remineralize enamel subsurface lesions.


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