Effect of casein phosphopeptide-amorphous calcium phosphate on the microhardness and microscopic features of the sound enamel and initial caries-like lesion of permanent teeth, compared to fluoridated agents


Background: Casein phosphopeptide-amorphous calcium phosphate derived from the milk protein casein. The aimsof this study were to investigate the efficacy of CPP-ACP on the microhardness of the sound and artificially caries-likelesion of outer enamel surface in comparison to sodium fluoride 0.05%, stannous fluoride 0.4%, and de-ionized water.Materials and methods: Sixty five maxillary first premolars, two teeth were used for sound and caries- like lesionenamel ground section preparation, while other teeth were randomly divided into two groups, A and B. Group A wasconsisted of 42 teeth were randomly assigned to five study groups and one control group. After production of initialcaries-like lesion of outer enamel surface, the teeth were treated by the selected agents for four minutes separately(CPP-ACP, CPP-ACP+NaF, CPP-ACP+SnF2, NaF 0.05%, and SnF2 0.4%). While Group B consisted of 21 teeth wererandomly divided to three study groups, teeth treated with (CPP-ACP, CPP- ACP+NaF, CPP- ACP+SnF2) beforedemineralization by pH cycling procedure.Results: In both groups showed that agents of study groups were statistically highly significant in elevation of themicrohardness values, CPP-ACP+NaF caused highest change in the microhardness (207.21%) for Group A and(19.22%) for Group B, while the lowest change with SnF2 0.4% (74.32%) for Group A and CPP-ACP (8.2%) for Group B.Conclusions: CPP-ACP agents were effective in remineralization of the outer enamel caries-like lesions and the higherremineralizing potential when applied with fluoridated agents; which was reflected by increase in enamelmicrohardness values.