The role of casein phosphopeptide-amorphous calcium phosphate products in remineralization of incipient enamel lesions and its substantivity

Objective: Milk derived calcium, phosphate and casein were known to be anti-cariogenic but in the modern era of early interception of caries the agents like casien phosphopeptide-amorphous calcium phosphate (CPP-ACP) derived from milk are known to also repair early lesions. This in vitro study was designed to evaluate the remineralizing potential of CPP-ACP and CPP-amorphous calcium phosphate fluoride (ACPF) on smooth surface carious lesions of the enamel and its substantivity following demineralization. Methods: Sixty caries free molar and premolars included in the study were sectioned and assigned to two experimental groups in which samples were remineralized with CPP-ACP or CPP-ACPF. The remineralization caused by CPP-ACP was evaluated using laser fluorescence device. Samples were then demineralized to evaluate the substantivity of remineralization. Results: CPP-ACPF and CPP-ACP showed significantly higher remineralization than baseline levels. On the other hand, CPP-ACPF showed significantly less demineralization than CPP-ACP. Conclusion: The remineralization produced by CPP-ACPF is more stable to further demineralization probably attributed to presence of fluoride. Addition of fluoride was shown to be protective from subsequent demineralization challenges.