Evaluation of Remineralizing Efficacy of Calcium Sucrose Phosphate: A Systematic Review of In Vitro Studies

Abstract

Background: Despite improved oral hygiene regime and availability of preventive formulations, dental caries continues to be a global dental problem. Calcium sucrose phosphate (CaSP) is a remineralizing agent with cariostatic action, which is commonly available in the form of tooth cream. Considering the paucity of evidence, this systematic literature review aims to evaluate the remineralizing efficacy of CaSP. Methodology: The review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Various databases, including PubMed, Cochrane Central, and Google Scholar, were searched until March 15, 2018 and were assessed for inclusion by two independent reviewers. The primary outcome was to assess the remineralizing efficacy of CaSP, and the secondary outcome was to assess the potential of CaSP in arresting white spot lesion(s) on enamel. Results: Out of 2,876 articles, only 13 were qualified for inclusion. Included studies presented a low risk of bias for the following items: caries-free teeth or restoration, and adherence to manufacture’s instruction for the usage of remineralizing agent in the risk of bias scale. Ten studies reported an increase in the microhardness of enamel after CaSP application, and three studies reported the effect of CaSP on arresting white spot lesion(s). CaSP was found to be a better remineralizing agent in comparison to casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) and other remineralizing agents in terms of increasing microhardness of enamel. In addition, CaSP application was also found to have a beneficial effect in restoring the color of white spot lesion(s) to that of normal enamel. Conclusion: CaSP tooth cream was found to be an effective remineralizing agent, compared to others, such as CPP-ACP and CPP-ACPF, in terms of increasing the mean microhardness of enamel and arresting white spot lesion(s).

Comparative evaluation of remineralization potential of four different remineralization agents on human enamel: An in vitro study

“…Although fluoride remains the best agent for REM,[ 9 10 ] other calcium–phosphate-based agents in various formulations are also being used. Some of the commonly used agents such as casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF; GC – Tooth Mousse Plus ® ),[ 11 ] tricalcium phosphate fluoride (TCP-F; 3M™ ClinPro™ crème 0.21% sodium fluoride anticavity toothpaste),[ 12 ] calcium sucrose phosphate (CSP) (Toothmin Toothpaste),[ 13 ] and self-assembling peptide P11-4 (CURODONT™ REPAIR, credentis AG)[ 14 ] are also capable of remineralizing initial DEM.…”

Evaluation of efficacy of various remineralizing agents on artificially demineralized human enamel – An in-vitro study

“…Remineralization is the natural process to halt the process of demineralization of enamel which stop or reverse the progressing lesion and is based on calcium, phosphate ions with the help of fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. [5][6][7][8][9] This In-Vitro study was undertaken to compare the efficacy of remineralizing agents containing Casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP), Functionalized tri-calcium phosphate (f-TCP), Calcium sodium phosphosilicate (CSPS), Calcium sucrose phosphate (CSP), Nano hydroxyapatite (nHAP) and Fluoride (F) on remineralization of WSL using DIAGNO dent instrument (KaVo, Germany) and SEM.…”