engleski

Effect of fluorides, casein phosphopeptides and amorphous calcium phosphate on white spot lesion regression

Introduction: Topical fluorides may reduce enamel demineralization and reverse white spot lesions at limited success. The aim of this study was to determine the effectiveness of topical fluoride and/or casein phosphopeptide (CPP) amorphous calcium phosphate (ACP) preparations in treating enamel demineralization as white spot lesions, based on published clinical trials in past ten years. Methods: The search with keywords fluoride, casein phosphopeptide amorphous calcium, and white spot was reached through PubMed website (US National Library of Medicine, National Institute of Health) for the literature published from January 2003 to November 2013. The database was searched for randomized controlled trials (RCTs) or clinical controlled trials (CCTs). Trials with the presence or absence of white spot lesion improvement as the primary outcome, as well as with the fluoride treatment and casein phosphopeptide-amorphous calcium phosphate treatments, were included. Two reviewers independently read and analysed the papers, and extracted data assessing the methodological quality, results and the conclusion of each trial. Results: There were 18 articles identified by screening titles and abstracts. Analysis of the methodologies and study designs revealed that 11 reports were RCTs or CCTs, one observational, one longitudinal and 5 studies included in-vitro experiments as well. Among RCTs and CCTs there were 5 trials supporting CPP-ACP preparations combined with fluorides superior in white spot regression when compared to fluorides only or placebo. Also, other 6 RCTs and CCTs found no significant clinical differences between CPP-ACP and the fluoride groups against demineralization. Conclusion: Topical fluoride and/or CPP-ACP preparations reduced the size of enamel demineralization, but without evidence that any preparation was superior to other. There is a need for high quality clinical research on the different modes of delivering fluoride and/or CPP-ACP to enhance clinical relevance of future topical preparation use for white spot lesion treatment.

fluoride; casein phosphopeptide amorphous calcium; white spot

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