Remineralization of Calcium Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on Caries-like Lesions

Objective: to investigate the efficacy of CPP-ACP containing Tooth Mousse on the remineralization of enamel lesions and to compare its efficacy when used together with a fluoride containing toothpaste. Methods: Extracted permanent third molars were painted with nail varnish leaving 1 mm wide window on buccal and/or lingual surface(s). The teeth were then placed in demineralizing solution for 96 hours to produce artificial carious like lesions 120-200µm in depth. They were sectioned into 100-150µm thick samples and randomly assigned to five groups; for Group A, a 1100ppm fluoridated toothpaste (Colgate Total, Bangkok, Thailand) was used as a positive control, in Group B, a non-fluoridated toothpaste (Vicco Laboratories, India) was used as a negative control. Tooth Mousse containing CPP-ACP (Tooth Mousse, GC Corp, Tokyo, Japan) was tested by three different means: as a toothpaste (Group C); as a topical coating (Group D); and (Group E) as topical coating after treating the sections with the same fluoridated toothpaste as in Group A. Each group was treated under an in vitro pH cycling for 10 days. Polarized Light Microscopy and Microradiography were used to evaluate and compare the lesion characteristics before and after the treatments. Results: The lesion depth decreased significantly by 7% in Group A, 10.1% in Groups C and D and 13.1% in Group E (Paired t- test, p<0.05), while in Group B the lesion depth increased significantly by 23%. Conclusions: Based on the data obtained, CPP-ACP containing Tooth Mousse remineralized initial enamel lesions and it showed a higher remineralizing potential when applied as a topical coating after the use of fluoridated toothpaste.