Whelton HP, Spencer AJ, Do LG, Rugg-Gunn AJ. Fluoride revolution and dental caries: evolution of policies for global use. J Dent Res. 2019; 98:837-846
Biesbrock AR, Faller R V, Bartizek RD Reversal of incipient and radiographic caries through the use of sodium and stannous fluoride dentifrices in a clinical trial. J Clin Dent. 1998; 9:5-10
Duckworth RM, Horay C, Huntington E, Mehta V. Effects of flossing and rinsing with a fluoridated mouthwash after brushing with a fluoridated toothpaste on salivary fluoride clearance. Caries Res. 2009; 43:387-390
ten Cate JM. Contemporary perspective on the use of fluoride products in caries prevention. Br Dent J. 2013; 214:161-167
Memarpour M, Fakhraei E, Dadaein S, Vossoughi M. Efficacy of fluoride varnish and casein phosphopeptide-amorphous calcium phosphate for remineralization of primary teeth: a randomized clinical trial. Med Princ Pract. 2015; 24:231-237
Marinho VC, Higgins JP, Logan S, Sheiham A. Topical fluoride (toothpastes, mouthrinses, gels or varnishes) for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2003; 2003:(4)
Nordström A, Birkhed D. Preventive effect of high-fluoride dentifrice (5,000ppm) in caries-active adolescents: a 2-year clinical trial. Caries Res. 2010; 44:323-331
Mannaa A, Campus G, Carlén A, Lingström P. Caries-risk profile variations after short-term use of 5000ppm fluoride toothpaste. Acta Odontol Scand. 2014; 72:228-234
Stookey GK. Review of fluorosis risk of self-applied topical fluorides: dentifrices, mouthrinses and gels. Community Dent Oral Epidemiol. 1994; 22:181-186
Wong MC, Glenny AM, Tsang BW Topical fluoride as a cause of dental fluorosis in children. Cochrane Database Syst Rev. 2010; 2010:(1)
Guidelines on the use of fluoride in children: an EAPD policy document. Eur Arch Paediatr Dent. 2009; 10:129-135
Lynch RJM, Smith SR. Remineralization agents – new and effective or just marketing hype?. Adv Dent Res. 2012; 24:63-67
Amaechi BT. Remineralisation – the buzzword for early MI caries management. Br Dent J. 2017; 223:173-182
Darvell BW. Surfaces.: Elsevier; 2018
Paes Leme AF, Dalcico R, Tabchoury CPM In situ effect of frequent sucrose exposure on enamel demineralization and on plaque composition after APF application and F dentifrice use. J Dent Res. 2004; 83:71-75
Bonow MLM, Azevedo MS, Goettems ML, Rodrigues CRMD. Efficacy of 1.23% APF gel applications on incipient carious lesions: a double-blind randomized clinical trial. Braz Oral Res. 2013; 27:279-285
Llena C, Leyda AM, Forner L. CPP-ACP and CPP-ACFP versus fluoride varnish in remineralisation of early caries lesions. A prospective study. Eur J Paediatr Dent. 2015; 16:181-186
Fredrick C, Krithikadatta J, Abarajithan M, Kandaswamy D. Remineralisation of occlusal white spot lesion with a combination of 10% CPP-ACP and 0.2% sodium fluoride evaluated using Diagnodent: a pilot study. Oral Health Prev Dent. 2013; 11:191-196
Andersson A, Sköld-Larsson K, Hallgren A Effect of a dental cream containing amorphous cream phosphate complexes on white spot lesion regression assessed by laser fluorescence. Oral Health Prev Dent. 2007; 5:229-233
Morgan MV, Adams GG, Bailey DL The anticariogenic effect of sugar-free gum containing CPP-ACP nanocomplexes on approximal caries determined using digital bitewing radiography. Caries Res. 2008; 42:171-184
Bailey DL, Adams GG, Tsao CE Regression of post-orthodontic lesions by a remineralizing cream. J Dent Res. 2009; 88:1148-1153
Rao SK, Bhat GS, Aradhya S Study of the efficacy of toothpaste containing casein phosphopeptide in the prevention of dental caries: a randomized controlled trial in 12-to 15-year-old high caries risk children in Bangalore, India. Caries Res. 2009; 43:430-435
Robertson MA, Kau CH, English JD MI Paste Plus to prevent demineralization in orthodontic patients: a prospective randomized controlled trial. Am J Orthod Dentofac Orthop. 2011; 140:660-668
Güçlü ZA, Alaçam A, Coleman NJ. A 12-week assessment of the treatment of white spot lesions with CPP-ACP paste and/or fluoride varnish. Biomed Res Int. 2016; 2016:1-9
Heravi F, Ahrari F, Tanbakuchi B. Effectiveness of MI Paste Plus and Remin Pro on remineralization and color improvement of postorthodontic white spot lesions. Dent Res J (Isfahan). 2018; 15
Bröchner A, Christensen C, Kristensen B Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate. Clin Oral Investig. 2011; 15:369-373
Huang GJ, Roloff-Chiang B, Mills BE Effectiveness of MI Paste Plus and PreviDent fluoride varnish for treatment of white spot lesions: a randomized controlled trial. Am J Orthod Dentofac Orthop. 2013; 143:31-41
Singh S, Singh SP, Goyal A Effects of various remineralizing agents on the outcome of post-orthodontic white spot lesions (WSLs): a clinical trial. Prog Orthod. 2016; 17:35-40
Sitthisettapong T, Phantumvanit P, Huebner C, DeRouen T. Effect of CPP-ACP paste on dental caries in primary teeth. J Dent Res. 2012; 91:847-852
Sitthisettapong T, Doi T, Nishida Y Effect of CPP-ACP paste on enamel carious lesion of primary upper anterior teeth assessed by quantitative light-induced fluorescence: a one-year clinical trial. Caries Res. 2015; 49:434-441
Beerens MW, Van Der Veen MH, Van Beek H, Ten Cate JM. Effects of casein phosphopeptide amorphous calcium fluoride phosphate paste on white spot lesions and dental plaque after orthodontic treatment: a 3-month follow-up. Eur J Oral Sci. 2010; 118:610-617
Li J, Xie X, Wang Y, Yin W Long-term remineralizing effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on early caries lesions in vivo: a systematic review. J Dent. 2014; 42:769-777
Fontana M. Enhancing fluoride: clinical human studies of alternatives or boosters for caries management. Caries Res. 2016; 50:22-37
Wang Y, Li J, Sun W, Li H Effect of non-fluoride agents on the prevention of dental caries in primary dentition: a systematic review. PLoS One. 2017; 12
Hay KD, Thomson WM. A clinical trial of the anticaries efficacy of casein derivatives complexed with calcium phosphate in patients with salivary gland dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93:271-275
de Oliveira PRA, Barreto LSDC, Tostes MA. Effectiveness of CPP-ACP and fluoride products in tooth remineralization. Int J Dent Hyg. 2022; 20:635-642
Alkilzy M, Tarabaih A, Santamaria RM, Splieth CH. Self-assembling peptide P11-4 and fluoride for regenerating enamel. J Dent Res. 2018; 97:148-154
Doberdoli D, Bommer C, Begzati A Randomized clinical trial investigating self-assembling peptide P11-4 for treatment of early occlusal caries. Sci Rep. 2020; 10
Bröseler F, Tietmann C, Bommer C Randomised clinical trial investigating self-assembling peptide P11-4 in the treatment of early caries. Clin Oral Investig. 2020; 24:123-132
Kondelova PS, Mannaa A, Bommer C Efficacy of P11-4 for the treatment of initial buccal caries: a randomized clinical trial. Sci Rep. 2020; 10
Kobeissi R, Osman E, Badr SB. Effectiveness of self-assembling peptide P11-4 compared to tricalcium phosphate fluoride varnish in remineralization of white spot lesions: a clinical randomized trial. Int J Clin Pediatr Dent. 2021; 13:451-456
Schlee M, Schad T, Koch JH Clinical performance of self-assembling peptide P11-4 in the treatment of initial proximal carious lesions: a practice-based case series. J Investig Clin Dent. 2018; 9
Welk A, Ratzmann A, Reich M Effect of self-assembling peptide P11-4 on orthodontic treatment-induced carious lesions. Sci Rep. 2020; 10
Brunton PA, Davies RPW, Burke JL Treatment of early caries lesions using biomimetic self-assembling peptides – a clinical safety trial. Br Dent J. 2013; 215:E6-E6
Schlee M, Rathe F, Huck T Klinischer Effekt biomimetischer Mineralisation bei Approximalkaries. Stomatologie. 2014; 111:175-181
Hench LL. The story of Bioglass. J Mater Sci Mater Med. 2006; 17:967-978
Hoffman DA, Clark AE, Rody WJ A prospective randomized clinical trial into the capacity of a toothpaste containing NovaMin to prevent white spot lesions and gingivitis during orthodontic treatment. Prog Orthod. 2015; 16
Bakry A, Abbassy M, Alharkan H A novel fluoride containing bioactive glass paste is capable of re-mineralizing early caries lesions. Materials (Basel). 2018; 11
Ramadoss R, Padmanaban R, Subramanian B. Role of bioglass in enamel remineralization: existing strategies and future prospects – a narrative review. J Biomed Mater Res B Appl Biomater. 2022; 110:45-66
Pascual A, Muñoz C, Silva A Effects of fluoride and calcium phosphate-based varnishes on pH, lactic acid, and trace elements in saliva: a randomized clinical trial. 2020; https://doi.org/10.21203/rs.3.rs-33730/v2
Thaper R, Karlinsey RL. Clinical observations on the remineralization of stage 1 enamel caries lesions using a tray-based protocol: a case report. Int J Dent Oral Heal. 2016; 2:1-4
Damyanova DD, Angelova DS, Targova-Dimitrova DT. Clinical study remineralization effect of mineralization varnish. IOSR J Dent Med Sci. 2016; 15:134-136
Badr S, Ragab H. The effectiveness of a nano-hydroxyapatite paste and a tri-calcium phosphate fluoride varnish in white spot lesions remineralization (randomized clinical trial). Egypt Dent J. 2018; 64:2757-2765
Kau CH, Wang J, Palombini A Effect of fluoride dentifrices on white spot lesions during orthodontic treatment: a randomized trial. Angle Orthod. 2019; 89:365-371
AlFeel J, Laflouf M, AlKurdi S, Alkhouli M. Evaluating the effect of Clinpro Tooth Crème on remineralization of pre-carious white spot lesions in anterior primary teeth: randomized controlled clinical trial. Pediatr Dent J. 2021; 31:152-158
Thompson A, Grant LP, Tanzer JM. Model for assessment of carious lesion remineralization, and remineralization by a novel toothpaste. J Clin Dent. 1999; 10:34-39
Mundorff-Shrestha SA, Proskin HM, Winston AE Cariostatic effect of a two-part fluoride dentifrice in rats. J Clin Dent. 1999; 10:26-29
Papas A, Russell D, Singh M Double blind clinical trial of a remineralizing dentifrice in the prevention of caries in a radiation therapy population. Gerodontology. 1999; 16:2-10
Papas A, Russell D, Singh M Caries clinical trial of a remineralising toothpaste in radiation patients. Gerodontology. 2008; 25:76-88
Chen L, Al-Bayatee S, Khurshid Z Hydroxyapatite in oral care products – a review. Materials (Basel). 2021; 14
Makeeva IM, Polyakova MA, Avdeenko OE Effect of long term application of toothpaste Apadent Total Care Medical nano-hydroxyapatite. Stomatologiya. 2016; 95:34-6
Hegazy SA, Salama RI. Antiplaque and remineralizing effects of Biorepair mouthwash: a comparative clinical trial. Pediatr Dent J. 2016; 26:89-94
Paszynska E, Pawinska M, Gawriolek M Impact of a toothpaste with microcrystalline hydroxyapatite on the occurrence of early childhood caries: a 1-year randomized clinical trial. Sci Rep. 2021; 11
Schlagenhauf U, Kunzelmann K, Hannig C Impact of a non-fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries-susceptible orthodontic patients: a randomized, controlled 6-month trial. J Investig Clin Dent. 2019; 10
Grocholewicz K, Matkowska-Cichocka G, Makowiecki P Effect of nano-hydroxyapatite and ozone on approximal initial caries: a randomized clinical trial. Sci Rep. 2020; 10
Professor of Cariology & Operative Dentistry, Hon Consultant in Restorative Dentistry, King's College London Dental Institute at Guy's Hospital, KCL, King's Health Partners, London, UK
The successful commercialization of mineralization technologies used for the primary and secondary prevention of early carious lesions provides several clinical options for the oral healthcare team using the minimum intervention oral care (MIOC) delivery framework. These new technologies are available in many different forms, with different properties, and can be used in a variety of clinical scenarios. This article is the second in a series providing a review on the clinical efficacy of new technologies and the products available, as well as clinical guidance for their use.
CPD/Clinical Relevance: Clinicians should have an appreciation of the different mineralizing agents available, and their related guidelines.
Article
The prevalence of dental caries worldwide has seen a steady decline in the past 50 years, largely due to the wide use of fluoride.1 Typically, early carious lesions (white spot lesions) are present on tooth surfaces most commonly missed during oral hygiene, and where plaque accumulates easily – the proximal (Figure 1) and cervical margins (Figure 2). Fluoridated products are still considered the most efficient way to prevent and remineralize carious lesions. However, fluoride on its own does not remineralize carious lesions. It requires the presence of other mineral ions present within the oral cavity. With advances in the understanding of the mechanisms of carious lesion formation and progression and the chemistry of remineralization/mineral deposition, new therapies have been developed. Their remineralization chemistry has been investigated comprehensively in laboratory studies and discussed in Part 1 of this review. Some of these new technologies have been commercialized, with various clinical benefits claimed by the manufacturers.
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
