2014, Number 2
<< Back Next >>
Rev Invest Clin 2014; 66 (2)
Preventive and remineralization effect over incipient lesions of caries decay by phosphopeptic phosphate of calcium amorfous
Juárez-López MLA, Hernández-Palacios RD, Hernández-Guerrero JC, Jiménez-Farfán D, Molina-Frechero N
Language: Spanish
References: 42
Page: 144-151
PDF size: 220.11 Kb.
ABSTRACT
Introduction. Dental caries continues to affect a large percentage
of Mexican children and currently advises that if
diagnosed at an early stage can be reversed with minimally
invasive treatments. The casein phosphopeptide amorphous
calcium phosphate known as CPP-ACP is a phosphoprotein
capable of releasing calcium and phosphate ions in the oral
environment promoting remineralization.
Objective. To
evaluate the effect of CPP-ACP with fluoride added in a
scholar preventive program.
Material and methods. A cuasi-
experimental study was conducted in 104 schools of six
years old. The children were classified into three groups and
received six months biweekly applications of different treatments:
casein phosphopeptide amorphous calcium phosphate
added fluoride (CPP-ACPF), sodium fluoride (NaF) and a
control group. Clinical evaluation was performed with the
laser fluorescence technique (Diagnodent model 2095). 1340
teeth were included: 294 teeth with incipient lesions and
1,046 healthy teeth. Statistical tests of
χ
2 y Mc Nemar were
used.
Results. In the group that received the application of
CPP-ACPF, 38% of incipient carious lesions were remineralizing
compared with 21% in the group receiving the NaF (p ‹
0.001) and 15% in the control group (p ‹ 0.0001) The percentage
of teeth free of caries were preserved in the therapy
group phosphoprotein was the biggest. This group also
showed the lower proportion of deep carious lesion development
(p ‹ 0.0001).
Conclusion. The application biweekly for
six months of CPP-ACPF showed a protective and remineralizing
effect on incipient carious lesions. His action was better
than the application of NaF. However, to reduce the
impact from dental caries in schoolchildren is important to
have a comprehensive preventive approach that includes promoting
self-care, as well as the application of sealants.
REFERENCES
Pereira SM, Tagliaferro EP, Ambrosano GM, Cortelazzi KL, Meneghim MC, Pereira AC. Dental caries in 12-year-old schoolchildren and its relationship with socioeconomic and behavioural variables. Oral Health Prev Dent 2007; 5(4): 299- 306.
Casanova-Rosado AJ, Medina-Solís CE, Casanova-Rosado JF, Vallejos-Sánchez AA, Maupomé G, Avila-Burgos L. Dental caries and associated factors in Mexican schoolchildren aged 6-13 years. Acta Odontol Scand 2005; 63(4): 245-51.
Armfield JM, Spencer AJ. Changes in South Australian children’s caries experience: is caries re-surfacing? Aust Dent J 2004; 49(2): 98-100.
Juárez-López LA, Murrieta-Pruneda F, Ortiz-Cruz E. Prevalencia de caries y su asociación con el estado nutricional y hábitos higiénicos en preescolares. Rev AMOP 2006; 18(2): 28-32.
Segovia-Villanueva A, Estrella-Rodríguez R, Medina-Solís CE, Maupomé G. Caries severity and associated factors in preschool children aged 3-6 years old in Campeche City, Mexico. Rev Salud Publica 2005; 7(1): 56-69.
Secretaría de Salud. Subsecretaría de Prevención y Promoción de la Salud. Resultados del Sistema de Vigilancia Epidemiológica de Patologías Bucales. SIVEPAB 2011. México, 2012.
Carrillo-Sánchez C. Desmineralización y remineralización, el proceso en balance y la caries dental. Revista ADM 2010; 67(1): 30-2.
Portilla Robertson J, Pinzon Tofiño ME, Huerta Leyva ER, Obregón Parlange A. Conceptos actuales e investigaciones futuras en el tratamiento de la caries dental y control de la placa dentobacteriana. Revista de Odontología Mexicana 2010; 14(4): 218-25.
Fejerskov O, Kidd E. Dental caries. The disease and its clinical management. 2nd ed. USA: Blackwell Munksgaard Ltd; 2008: 90-9.
Chen F, Wang D. Novel technologies for the prevention and treatment of dental caries: a patent survey. Expert Opin Ther Pat 2010; 20(5): 681-94.
Nongonierma AB, Fitzgerald RJ. Biofunctional properties of caseinophos phopeptides in the oral cavity. Caries Res 2012; 46(3): 234-67.
Rahiotis C, Vougiouklakis G. Effect of a CPP-ACP agent on the demineralization and remineralization of dentine in vitro. J Dent 2007; 35(8): 695-8.
Wu G, Liu X, Hou Y. Analysis of the effect of CPP-ACP tooth mousse on enamel remineralization by circularly polarized images. Angle Orthod 2010; 80(5): 933-8.
Srinivasan N, Kavitha M, Loganathan SC. Comparison of the remineralization potential of CPP-ACP and CPP-ACP with 900 ppm fluoride on eroded human enamel: an in situ study. Arch Oral Biol 2010; 55(7): 541-4.
Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phospho peptide on enamel lesions: an in vitro comparative evaluation. J Conserv Dent 2010; 13(1): 42-6.
Murrieta Pruneda F, Juárez López MLA. Índices epidemiológicos de morbilidad bucal en México. FES Zaragoza. UNAM; 2006.
Kavo Diagnodent 2095. Manual del usuario. Kavo Dental Excellence. P. 18-23.
Lussi A, Hellwig E. Performance of a new laser fluorescence device for the detection of occlusal caries in vitro. J Dent 2006; 34(7): 467-71.
Lussi A, Mergert B, Longbotton C, Reich E, Francescut P. Clinical Performance of laser fluorescence device for detection of occlusal caries lesions. Eur J Oral Sci 2001; 109: 14-9.
Kavo. Clinical Guidelines and brief operating instructions. Kavo Diagnodent 2095. Disponible en www.smilehelp.com/ patient_Ed/DIAGNOdent_Clinical_Guidelines.pdf.
Walsh L. Aspectos clínicos de biología salival para el clínico dental. J Minim Interv Dent 2008; 1(1): 5-23.
Peters MC. Strategies for noninvasive demineralized tissue repair. Dent Clin North Am 2010; 54(3): 507-25.
Rose RK. Effects of an anticariogenic casein phosphopeptide on calcium diffusion in streptococcal model dental plaques. Arch Oral Biol 2000; 45(7): 569-75.
Ten Cate JM. Current concepts on the theories of the mechanism of action of fluoride. Acta Odontol Scand 1999; 57(6): 325-9.
Cochrane NJ, Cai F, Huk NL, Burrow MF, Reynols EC. New approaches to enhanced demineralization of tooth enamel. J Dent Res 2010; 89(11): 1187-97.
Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res 1997; 76(9): 1587-95.
Shen P, Manton DJ, Cochrane NJ, Walker GD, Yuan Y, Reynolds C, Reynolds EC. Effect of added calcium phosphate on enamel remineralization by fluoride in a randomized controlled in situ trial. J Dent 2011; 39(7): 518-25.
Rodrigues JA, Lussi A, Seemann R, Neuhaus KW. Prevention of crown and root caries in adults. Periodontol 2000 2011; 55(1): 231-49.
Pinheiro AI, Medeiros SM, Ferreira FM, Lima KC. Uso de fluorescencia láser (DIAGNOdent®) para diagnóstico in vivo de caries oclusales: un análisis sistemático. J Minim Interv Dent 2008; 1(1): 47-53.
Jablonski-Momeni A, Struke J, Steinberg T, Heinzel-Gutembrunner M. Use of ICDAS-II, fluorescence-based methods, and radiography in detection and treatment decision of occlusal caries lesions: an in vitro study. Int J Dent 2012; ID 371595. Disponible en: http://dx.doi.org/10.1155/2012/371595.
Krithikadatta J, Fredrick C, Abarajithan M, Kandaswamy D. Remineralization of occlusal white spot lesion with a combination of 10% CPP-ACP and 0.2% sodium fluoride evaluated using Diagnodent: a pilot study. Oral Health Prev Dent 2013; 11(2): 191-6.
Zhang Q, Zou J, Yang R, Zhou X. Remineralization effects of casein phosphopeptide-amorphous calcium phosphate creme on artificial early enamel lesions of primary teeth. Int J Paediatr Dent 2011; 21(5): 374-81.
Robertson MA, Kau CH, English JD, Lee RP, Powers J, Nguyen JT. MI Paste Plus to prevent demineralization in orthodontic patients: a prospective randomized controlled trial. Am J Orthod Dentofacial Orthop 2011; 140(5): 660-8.
Somasundaram P, Vimala N, Mandke LG. Protective potential of casein phosphopeptide amorphous calcium phosphate containing paste on enamel surfaces. J Conserv Dent 2013; 16(2): 152-6.
Balakrishnan A, Jonathan R, Benin P, Kuumar A. Evaluation to determine the caries remineralization potential of three dentifrices: An in vitro study. J Conserv Dent 2013; 16(4): 375-9.
Bailey DL, Adams GG, Tsao CE, Hyslop A, Escobar K, Manton DJ, Reynolds EC, et al. Regression of post-orthodontic lesions by a remineralizing cream. J Dent Res 2009; 88(12): 1148-53.
Andersson A, Sköld-Larsson K, Hallgren A, Petersson LG, Twetman S. Effect of a dental cream containing amorphous cream phosphate complexes on white spot lesion regression assessed by laser fluorescence. Oral Health Prev Dent 2007; 5(3): 229-33.
Uysal T, Amasyall M, Koyuturk AE. Effects of different topical agents on enamel demineralization around orthodontic brackets: an in vivo and in vitro study. Australian Dent J 2010; 55: 268-74.
Bröchner A, Christensen C, Kristensen B, Tranaeus S, Karlsson L, Sonnensen L, Twetman S. Treatment of post orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate. Clin Oral Investig 2011; 15(3): 369-73.
Sitthisettapong T, Phantumvanit P, Huebner C, Derouen T. Effect of CPP-ACP paste on dental caries in primary teeth: a randomized trial. J Dent Res 2012; 91(9): 847-52.
Wegehaupt FJ, Tauböcck TT, Stillhard A, Schmidlin R, Attin T. Influence of extra and intra oral application of CPP-ACP and fluoride on rehardening of eroded enamel. Acta Odont Scand 2012; 7(3): 177-83.
Marinho VC, Higgins JP, Logan S, Sheihan A. Fluoride gels for preventing dental caries in children and adolescents. (Cochrane collaboration) en la biblioteca Cochrane en línea: Oral Heath group 2009. Disponible en: http://onlinelibrary. wiley.com/doi/10.1002/14651858.CD002280/abstract