CPP-ACP Promotes SnF₂ Efficacy in a Polymicrobial Caries Model

Area of Science:

• Oral microbiology
• Biomaterials science
• Cariology

Background:

• Dental caries results from plaque dysbiosis, favoring acidogenic bacteria.
• Stannous fluoride (SnF2) aids remineralization and may inhibit bacterial glycolysis.
• Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) enhances fluoride remineralization and may alter plaque composition.

Purpose of the Study:

• To investigate the mechanisms of action of SnF2 and CPP-ACP in a polymicrobial biofilm model of dental caries.
• To evaluate the efficacy of SnF2, CPP-ACP, and their combination in preventing enamel demineralization.

Main Methods:

• A polymicrobial biofilm model using six representative supragingival plaque species on human enamel was established.
• Biofilms were subjected to frequent sucrose challenges to simulate a high cariogenic environment.
• Bacterial composition was analyzed using 16S rRNA gene sequencing, and enamel demineralization was quantified by transverse microradiography.

Main Results:

• SnF2 treatment inhibited enamel demineralization by 50% with minimal impact on biofilm composition.
• CPP-ACP treatment also inhibited demineralization by 50% and altered bacterial profiles, decreasing Actinomyces naeslundii and Lactobacillus casei while increasing Streptococcus sanguinis and Fusobacterium nucleatum.
• The combination of SnF2 and CPP-ACP demonstrated synergistic effects, significantly suppressing acidogenic bacteria and achieving a 72% inhibition of enamel demineralization.

Conclusions:

• Both SnF2 and CPP-ACP are effective in inhibiting enamel demineralization in a caries biofilm model.
• CPP-ACP influences plaque composition, while SnF2 primarily acts on demineralization.
• The combination of SnF2 and CPP-ACP offers superior protection against dental caries by targeting both bacterial activity and demineralization processes.