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Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate

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Abstract

This study aims to investigate the effect of topical applications of 10% casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) on white spot lesions (WSL) detected after treatment with fixed orthodontic appliances. Sixty healthy adolescents with ≥1 clinically visible WSL at debonding were recruited and randomly allocated to a randomised controlled trial with two parallel groups. The intervention group was instructed to topically apply a CPP–ACP -containing agent (Tooth Mousse, GC Europe) once daily and the subjects of the control group brushed their teeth with standard fluoride toothpaste. The intervention period was 4 weeks and the endpoints were quantitative light-induced fluorescence (QLF) on buccal surfaces of the upper incisors, cuspids and first premolars and visual scoring from digital photos. The attrition rate was 15%, mostly due to technical errors, and 327 lesions were included in the final evaluation. A statistically significant (p < 0.05) regression of the WSL was disclosed in both study groups compared to baseline, but there was no difference between the groups. The mean area of the lesions decreased by 58% in the CPP–ACP group and 26% in the fluoride group (p = 0.06). The QLF findings were largely reflected by the clinical scores. No side effects were reported. Topical treatment of white spot lesions after debonding of orthodontic appliances with a casein phosphopeptide-stabilised amorphous calcium phosphate agent resulted in significantly reduced fluorescence and a reduced area of the lesions after 4 weeks as assessed by QLF. The improvement was however not superior to the “natural” regression following daily use of fluoride toothpaste.

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Acknowledgement

The study was partly supported by a grant from GC Europe (Belgium) who also provided the test product. The authors would like to thank Pia Hole, Marianne Knudsen, Birgitte Kristensen and Mirko Zelic for their skilful clinical and technical work.

Conflicts of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the performance and evaluation of the study protocol as well as for the content and writing of the paper.

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Authors and Affiliations

  1. Department of Orthodontics, Odense Central Clinic, Tandplejen Grønløkkevej 30, DK-5000, Odense C, Denmark

    Ann Bröchner, Carsten Christensen & Bjarne Kristensen

  2. Department of Dental Medicine, Cariology and Endodontology, Karolinska Institute, Alfred Nobels Allé 8, SE-141 04, Huddinge, Sweden

    Sofia Tranæus & Lena Karlsson

  3. Institute of Odontology, Section for Orthodontics, Faculty of Health Sciences, University of Copenhagen, Nørre Allé 20, DK-2200, Copenhagen N, Denmark

    Liselotte Sonnesen

  4. Institute of Odontology, Section for Cariology and Endodontics, Faculty of Health Sciences, Univeristy of Copenhagen, Nørre Allé 20, DK-2200, Copenhagen N, Denmark

    Svante Twetman

  5. Maxillofacial Unit, County Hospital, SE-301 85, Halmstad, Sweden

    Svante Twetman

Authors
  1. Ann Bröchner
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  2. Carsten Christensen
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  3. Bjarne Kristensen
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  4. Sofia Tranæus
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  5. Lena Karlsson
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  6. Liselotte Sonnesen
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  7. Svante Twetman
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Correspondence to Svante Twetman.

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Bröchner, A., Christensen, C., Kristensen, B. et al. Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate. Clin Oral Invest 15, 369–373 (2011). https://doi.org/10.1007/s00784-010-0401-2

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  • DOI: https://doi.org/10.1007/s00784-010-0401-2

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