The Use of Caries Preventive Agents Alone and in Regimen for Prevention of Enamel Demineralisation under Cariogenic Challenge in situ

Aim of the Research: To compare the efficacy of Casein Phosphopeptide- Stabilised Amorphous Calcium Fluoride Phosphate (CPP-ACFP) 900 ppm (MI Paste Plus™) combined with fluoride toothpaste 1450 ppm F as a regimen with Functionalised tri-calcium phosphate (f-TCP) 950 ppm (Clinpro tooth crème™) and fluoride toothpaste 1450 ppm F, on de/remineralisation dental enamel in an in situ randomised, cross-over design study. Materials and Methods: Sterilised bovine enamel slabs, intact and with subsurface caries-like lesions, were prepared and worn by healthy volunteers (n=14). The study had four arms, 21-day duration each. Four pastes were tested (i) Placebo (0-ppm), (ii) 1450 ppm F, (iii) MI Paste Plus combined fluoride toothpaste 1450 ppm F, (iv) Clinpro tooth crème 950 ppm F. The pastes were randomly assigned and each subject crossed over to each paste after a seven-day washout period. Slabs were subjected to a five times/day cariogenic challenge (12% sucrose) with the subjects using one of the treatments. Volunteers dipped their appliances twice/day for 2 minutes, in a slurry of the toothpastes. For group 3, additionally, the appliance was dipped for 3 min in a slurry MI Paste Plus once/day immediately following the second exposure to the slurry of 1450 ppm F. Further de/remineralisation were assessed using Quantitative Light-Induced Fluorescence (QLF) and Surface Microhardness before and after the treatment period. Results: QLF results for all test groups showed a significant reduction (p< 0.05) in lesion volume (ΔQ) compared to the placebo. No statistically significant differences were found between the test groups. The Microhardness results for all test groups showed a significant increase (p<0.05) of enamel hardness compared with the placebo. No statistically significant differences were found between the test groups. Conclusion: The use of MI Paste Plus in combination with 1450 ppm F toothpaste did not show a greater reduction of enamel subsurface lesions or decreased demineralisation of sound enamel in comparison to 1450 ppm F toothpaste and Clinpro tooth crème alone in our model.