Efficacy of Casein Phosphopeptide Amorphous Calcium Phosphate with and without Fluoride in Comparison with Fluoride Gel for Enamel Remineralization

1.1. Background and Objectives: Remineralization, as a treatment modality, has attracted the attention of dental clinicians. Recent studies on the role of casein and calcium phosphate derived from milk showed that casein phosphopeptide (CPP) complex stabilizes the calcium phosphate and leads to remineralization of incipient carious lesions. This study aimed to assess and compare the efficacy of casein phosphopeptide amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) and fluoride gel for remineralization of enamel carious lesions. 1.2. Materials and Methods: One-hundred extracted human premolars were divided into four groups of 25: artificial saliva (group A), CPP-ACP (group B), CPP-ACPF (group C) and fluoride gel (group D). The DIAGNOdent values of buccal tooth surfaces were measured at baseline, after demineralization and at seven, 14 and 21 days after remineralization. 1.3. Results: The mean DIAGNOdent value(remineralization rate)was 7.4, 6.96 and 8.16 in CPP-ACP, CPP-ACPF and fluoride gel groups, respectively at seven days, 7.04, 6.6 and 7 at 14 days and 6.48, 6.08 and 6.52, respectively at 21 days (ANOVA, P<0.05). At all three time points, remineralization of enamel lesions in the test groups was significantly higher than that in the control group but no significant difference was noted between the test groups in this respect. 1.4. Conclusion: CPP-ACP, CPP-ACPF and fluoride gel all showed significant efficacy for remineralization of demineralized enamel lesions. Also, CPP-ACPF (GC MI Paste Plus) caused greater remineralization than CPP-ACP (GC Tooth Mousse) and fluoride gel due to the incorporation of 0.2% NaF in its composition.