Caries preventive effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP): a meta-analysis

Area of Science:

• Dental Research
• Biomaterials Science
• Preventive Dentistry

Background:

• Dental caries remains a significant public health concern.
• Effective caries prevention strategies are continuously sought.
• Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is a biomaterial investigated for its potential remineralizing properties.

Purpose of the Study:

• To systematically review and meta-analyze the caries-preventive benefits of CPP-ACP.
• To compare the efficacy of CPP-ACP against other interventions and placebo.
• To evaluate both short-term remineralization and long-term caries prevention effects.

Main Methods:

• Systematic review and meta-analysis of electronic database searches.
• Inclusion and exclusion criteria applied to select relevant trials.
• Pooled analysis of five in situ randomized control trials (RCTs) for short-term effects.
• Analysis of one long-term in vivo RCT (24 months) for caries progression.

Main Results:

• Short-term in situ trials showed significant enamel remineralization with CPP-ACP in chewing gum compared to placebo or no intervention (p < 0.00001).
• A long-term in vivo RCT (n=2720) indicated an 18% reduction in caries progression odds with sugar-free gum containing CPP-ACP versus control (p = 0.03).

Conclusions:

• CPP-ACP exhibits a short-term remineralization effect in the oral environment.
• Promising in vivo results suggest a potential caries-preventing effect with long-term CPP-ACP use.
• Further in vivo randomized control trials are recommended to validate these findings.