Effect of casein phosphopeptide amorphous calcium fluoride phosphate and calcium glycerophosphate on incisors with molar-incisor hypomineralization: A cross-over, randomized clinical trial

Sezer, Berkant; Tuğcu, Nihan; Calışkan, Cansu; Durmuş, Başak; Купец, Татьяна Владимировна; Bekiroğlu, Nural; Kargül, Betül; Bourgeois, Denis

doi:10.3233/bme-211371

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…A comparison between the studies presented in Table 1 is difficult because many different techniques were used to measure the remineralizing effect on MIH-teeth, e.g., microcomputed tomography [ 25 ], transverse microradiography [ 23 ], microhardness test (Vickers) [ 42 ], laser fluorescence [ 46 , 47 , 48 ], Raman microscopy [ 43 ], energy dispersive spectroscopy [ 44 ], or scanning electron microscopy [ 28 ]. In most clinical studies, laser fluorescence was used to measure the in vivo remineralization effect ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review

Enax

Farah

Liu³

et al. 2023

Dentistry Journal

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Molar incisor hypomineralization (MIH) is a highly prevalent dental developmental disorder with a significant health burden for patients and high treatment needs, yet no comprehensive review article on all remineralization systems as a non-invasive treatment approach for MIH has been published. Typical characteristics of MIH-affected teeth are a lower mineral density and lower hardness compared to healthy teeth leading to sensitivity and loss of function. Thus, the use of formulations with calcium phosphates to remineralize MIH-affected teeth is reasonable. This review presents an up-to-date overview of remineralization studies focusing on active ingredients investigated for remineralization of MIH, i.e., casein phosphopeptide amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP), hydroxyapatite, calcium glycerophosphate, self-assembling peptide, and fluoride. Overall, 19 studies (in vitro, in situ, and in vivo) were found. Furthermore, an additional search for studies focusing on using toothpaste/dentifrices for MIH management resulted in six studies, where three studies were on remineralization and three on reduction of sensitivity. Overall, the studies analyzed in this review showed that MIH-affected teeth could be remineralized using calcium phosphate-based approaches. In conclusion, calcium phosphates like CPP-ACP, calcium glycerophosphate, and hydroxyapatite can be used to remineralize MIH-affected teeth. In addition to MIH-remineralization, CPP-ACP and hydroxyapatite also offer relief from MIH-associated tooth sensitivity.

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Section: Discussionmentioning

confidence: 99%

Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review

Enax

Farah

Liu³

et al. 2023

Dentistry Journal

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“…One other fluoride-free calcium-phosphate active ingredient that should have been considered but not included in the search was calcium glycerophosphate (CaGP), an active ingredient mentioned in the review by Enax et al [ 172 ] on the remineralization strategies of molar incisor hypocalcification. While this ingredient is used mainly to fortify fluoride toothpaste, it has only been tested in three clinical trials as an active ingredient without fluoride [ 173 , 174 , 175 ]. In those recent trials, it has been shown to be effective on its own and should really be counted as the fifth active ingredient for fluoride-free calcium-phosphate-containing toothpaste with the potential to reverse white spot lesions.…”

Section: Discussionmentioning

confidence: 99%

Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence

2023

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As the demand for clinically effective fluoride-free oral care products for consumers increases, it is important to document which types of toothpastes have been shown in clinical studies to be effective in improving oral health. In this review, we included different indications, i.e., caries prevention, improving periodontal health, reducing dentin hypersensitivity, protecting against dental erosion, and safely improving tooth whitening in defining what constitutes improvement in oral health. While there are several professional and consumer fluoride-containing formulations fortified with calcium-phosphate-based ingredients, this review focuses on fluoride-free toothpastes containing biomimetic calcium-phosphate-based molecules as the primary active ingredients. Several databases were searched, and only clinical trials in human subjects were included; in vitro and animal studies were excluded. There were 62 oral health clinical trials on biomimetic hydroxyapatite (HAP), 57 on casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), 26 on calcium sodium phosphosilicate (CSPS, or so called Bioglass), and 2 on β-tricalcium phosphate (β-TCP). HAP formulations were tested the most in clinical trials for benefits in preventing caries, dentin hypersensitivity, improving periodontal health, and tooth whitening. Based on the current clinical evidence to date, fluoride-free HAP toothpaste formulations are the most versatile of the calcium phosphate active ingredients in toothpastes for improving oral health.

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“…In this context, approaches to increasing mineral content have been investigated in the treatment of both white spot lesions and hypomineralized lesions observed in MIH and other developmental enamel defects [73,74]. In two different randomized in vivo studies by Sezer et al [75,76], the effects of different remineralization agents on white/creamy or yellow/brown demarcated opacities on the incisors affected by MIH were evaluated using the laser fluorescence method. As a result of the first study [75] using calcium glycerophosphate (CaGP), CPP-ACFP, and fluoridated toothpaste (as the control group), it was reported that agents containing CaGP and CPP-ACFP in addition to routine oral hygiene practices increased the mineral content of the lesions.…”

Section: Approaches To Increasing Mineral Contentmentioning

confidence: 99%

“…As a result of the first study [75] using calcium glycerophosphate (CaGP), CPP-ACFP, and fluoridated toothpaste (as the control group), it was reported that agents containing CaGP and CPP-ACFP in addition to routine oral hygiene practices increased the mineral content of the lesions. In the second study [76], patients used remineralization agents containing CaGP and CPP-ACFP in a cross-over design. It was reported that both agents increased the mineral content and provided remineralization after three months, regardless of the cross-over design.…”

Section: Approaches To Increasing Mineral Contentmentioning

confidence: 99%

Treatment Strategies for Incisors of Children Affected by Molar Incisor Hypomineralization: A Narrative Review

Sezer,

Çarıkçıoğlu

2024

Oral

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Today, molar incisor hypomineralization (MIH), which affects approximately one in seven children, is defined as a hypomineralized developmental enamel defect that often impacts at least one permanent first molar and frequently affects permanent incisors as well. Symptoms and signs include demarcated opacities of various colors, post-eruptive enamel deterioration, atypical caries and restorations, hypersensitivity, tooth loss due to MIH, and difficulty in achieving anesthesia. A detailed review of the scientific literature shows that there are many studies evaluating different treatment approaches for permanent first molars affected by MIH. On the other hand, there are very few scientific studies evaluating treatment approaches for affected incisors in patients with MIH. Most of these studies consist of case reports or series. White/creamy and/or yellow/brown demarcated opacities are commonly observed in affected incisors in patients with MIH. While these opacities increase the susceptibility of enamel to deterioration and dental caries, they also cause aesthetic problems and related psychosocial consequences. Treatment methods, such as resin infiltration, microabrasion, and/or dental bleaching, have been proposed for aesthetic and restorative purposes in affected incisors in patients with MIH. Additionally, various approaches to increase mineral content and relieve hypersensitivity have been recommended. The number of randomized controlled and prospective studies is quite low, but many case reports and case series have been encountered. The purpose of this review was to provide a comprehensive overview of the different treatment management modalities for permanent incisors affected by MIH. As a result, while resin infiltration, dental bleaching, microabrasion, and/or etch–bleach–seal techniques are preferred for aesthetic and restorative purposes in these teeth, it has been observed that agents containing casein phosphopeptide amorphous calcium phosphate, casein phosphopeptide amorphous calcium fluoride phosphate, fluoride, and calcium glycerophosphate increase the mineral content. Additionally, studies have reported that ozone and low-level laser therapy, in addition to these remineralizing agents, reduce hypersensitivity in these teeth. Although the findings of this review indicate that the level of evidence for current approaches is not high, clinicians may prefer one or more of the treatment approaches mentioned in this article based on experience and patient expectations.

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Effect of casein phosphopeptide amorphous calcium fluoride phosphate and calcium glycerophosphate on incisors with molar-incisor hypomineralization: A cross-over, randomized clinical trial

Cited by 5 publications

References 28 publications

Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review

Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review

Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence

Treatment Strategies for Incisors of Children Affected by Molar Incisor Hypomineralization: A Narrative Review

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