Amorphous calcium phosphate ACP 431 Cppacp paste

Due to the early stages of this technology, published independent research on the ACP products like MI Paste is limited. Generally, the studies on caries prevention with CPP-ACP consist of in-situ caries models with gums, mouthrinses, or lozenges (Iijima et al., 2004; Reynolds et al., 2003). In addition, the vast majority of these studies were carried out by the same group that first isolated CPP-ACP at the University of Melbourne, Australia. For example, using topical applications of CPP-ACP via sugar-free chewing gum and mouthrinse, Reynolds et al. showed that CPP-ACP incorporated into dental plaque can significantly increase the levels of plaque calcium and phosphate ions (Reynolds et al., 2003). Conversely, an in-vitro study carried out by an American group found that while fluoride 5000 ppm paste had a statistically significant protective effect against demineralization on enamel sections, MI Paste had no effect (Pulido et al., 2008).There are two published studies that examine the role of CPP-ACP paste in orthodontics. In an in-vitro study that assessed the demineralization around bonded molar tubes on extracted third molars, a mild decrease in demineralization was found with the application of CPP-ACP (Sudjalim et al., 2007). On the other hand, the authors of this very article recommended combining CPP-ACP with a fluoride gel to enhance the treatment effect. For the most part, clinicians loyal to the CPP-ACP protocol apply it without a fluoride gel, and the brochures by the manufacturer make no mention of additional rinses or gels. Andersson et al. conducted an in-vivo post-orthodontic treatment study, in which they compared the remineralization capabilities of 0.05% Sodium Fluoride mouthwash and the application of Topacal (CPP-ACP topical cream) on patients with white spot lesions. The study found significant remineralization with both protocols, and found no significant differences between the groups over time.

Still, the authors pointed out that the remineralization that occurred with CPP-ACP treatment was generally more esthetic than with the fluoride rinse.

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