Use of Casein Amorphous Calcium Phosphate (CPP-ACP) on White-spot Lesions: Randomised Clinical Trial

Purpose: To evaluate the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in the remineralisation of white-spot lesions in 80 anterior teeth of children aged 5-13 years enrolled in public schools of the city of Botucatu, São Paulo, Brazil. Materials and Methods: The study sample consisted of 36 individuals divided into 4 groups: G1. control (placebo paste); G2. fluoride gel; G3. CPP-ACP; G4: CPP-ACP + fluoride. Each product was applied twice by a calibrated examiner with a week of interval between. Lesions were monitored with a DIAGNOdent Pen before the first application, before the second application, and 1 and 3 months after the first application. To evaluate the lesion intensity, the Friedman test was applied, and to compare experimental groups, the Kruskal-Wallis test was applied. The analyses were complemented with the Dunn test and the level of significance was 5%. Results: At the end of the 90-day trial, the use of CPP-ACP and fluoride showed comparable results in terms of remineralisation. The best white-spot lesion remineralisation was observed when CPP-ACP and fluoride were combined. Conclusion: The use of CPP-ACP is a good alternative for the remineralisation of white-spot lesions. The effect can be improved when this product is applied in combination with fluoride. Palabras clave: CPP-ACP, dental enamel, fluoride, tooth remineralisation