Introduction: A randomized clinical trial was run testing Casein-Phosphopeptide Amorphous-Calcium-Phosphate Fluoride paste (CPP-ACPF) in orthodontic patients with multiple white spot lesions (WSL) supplementary to normal oral hygiene.
Aim: Evaluate the effect of CPP-ACPF on white spot lesions after fixed-appliance treatment and plaque composition during a three month period.
Materials and Methods: Caries and plaque composition were determined in 34 adolescent orthodontic patients at debonding. Patients with WSL were given CPP-ACPF (10) or placebo (10) to use once-a-day. Caries (integrated fluorescence loss (IFL)) was determined by quantitative light-induced fluorescence (QLF). Bacterial counts were enumerated (anaerobic, 37°C, 72 hrs) on blood agar (total counts), BHI (pH 5, aciduric bacteria), TYCSB (S. mutans) and Rogossa (lactobacilli).
Results: The number of lesions was comparable: CPP-ACPF 86; placebo 97. CPP-ACPF group showed tendency towards remineralization (-41%.mm²), while placebo-group seemed stable (-2%.mm²) but no difference between groups (p=0.063). Total counts for all groups and times were 5.107CFU. Aciduric bacteria and S. mutans comprised 46% and 11.5% of plaque in the caries-groups compared to 26% and 3.2% in the caries-free group (p<0.05). After 3 months aciduric bacteria and S. mutans in the CPP-ACPF-group reduced significantly to 25.6% and 3.8% (p<0.05) but were stable for the placebo-group.
Conclusion: CPP-ACPF tributes to a healthier plaque composition, although lesion reduction in this study was not yet significant,. Thus data suggest that CPP-ACPF paste may aid lesion reduction. A longer follow-up to investigate the effect of CPP-ACPF on lesion reduction is indicated.