Progression of erosion following use of calcium and phosphorus compounds

Objective: To assess whether pastes containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and calcium sodium phosphosilicate (CSP) control erosion progression. Methods: Enamel slabs of bovine teeth with preformed incipient erosion-like lesions were randomly assigned to five treatment groups (n=5): A) CPP-ACP (MI Paste, GC America); B) CPP-ACP+F (MI Paste Plus, GC America); C) CSP (Oravive); D) regular fluoridated dentifrice (Sensodyne Cool Gel, GSK); E) control (unexposed to any product). Paste treatments (1:3 slurry in deionized water or undiluted product in the case of the CPP-ACP formulae) were performed for 90s and followed by a 2-h period in artificial saliva (pH=6.8). Then, an alternating erosion-remineralization cycle consisting of immersion of specimens in 0.3% citric acid solution (pH=3.2, 90s) and artificial saliva for 4h was used. Paste treatments and erosion-remineralization cycle were repeated five times. Specimens were analyzed by surface microhardness (Knoop, 25g, 10s). Results: Mean (sd) values were: A) 213.2 (42.4); B) 234.3 (12.9); C) 234.1 (26.8); D) 246.5 (38.1); E) 172.3 (24.2), with [B=C=D]>E and A=E (p<0.05, ANOVA/Tukey). Conclusion: Treatment of eroded enamel with CPP-ACP+F and CSP reduced progression of erosion compared with the untreated control, but in a manner indistinguishable from that of the regular fluoridated toothpaste.