Remineralization of Eroded Teeth Using CPP-ACP Paste

Objectives:

Soft drinks can cause dental erosion.  Previous studies have shown that casein phosphopeptide amorphous calcium phosphate (CPP-ACP) has been effective in the remineralization of carious lesion. This in vitro study examined whether CPP-ACP paste can reharden enamel after slight erosion by Coke^®, and how different artificial saliva solutions affect the enamel hardness.

Methods:

Bovine teeth (n=15) were immersed in Coke^® for 8 minutes and then placed under artificial saliva solutions pumped at 0.4mL/min.  A total of 5 teeth (each tooth consisted of treatment and control halves) were subjected to different artificial saliva solutions: saliva like solution (SLS) with 1 ppm fluoride (F), SLS without F, and Biotene^® mouthwash.  CPP-ACP Paste was applied in the treatment group for 3 minutes at 0, 8, 24, and 36 hours.  Knoop microhardness (KHN) was measured at baseline, after Coke^® immersion, and after 24 and 48 hours contact with artificial saliva solution.

Results:

Enamel hardness significantly decreased after 8 minutes immersion in Coke^® and significantly changes with each treatment (ANOVA and SNK; p<0.05).  The table shows that specimens treated with CPP-ACP paste were significantly harder than those untreated after 48 hours under an artificial saliva solution drip.  However, the effect of 1 ppm fluoride in SLS was not significant.  Biotene^® mouthwash significantly softened the enamel surface. 

Table. Difference in KHN (Mean±SD) after 48 hours remineralization.  Superscripts denote mean values that are not significantly different (two-way ANOVA, p=0.05). 

	SLS with F	SLS without F	Biotene
CPP-ACP paste	41.7±30.5a	42.2±15.5a	-116.1±17.6c
No paste	14.6±21.0b	4.4±14.7b	-154.7±13.0d

Conclusion:

This study suggests that the application of CPP-ACP Paste along with saliva-like solution significantly hardened the enamel softened by Coke^®. Biotene^® mouthwash softened enamel surface after prolonged contact.

Supported by MDRCBB, the UMSOD summer research fellowship program and the William H. Crawford award.