The journal of contemporary dental practice · 2025
Evaluation of the Preventive Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on White Spot Lesions during Fixed Orthodontic Treatment Using Scanning Electron Microscopy.
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Anbarasu Prema, Bhattacharyya Amritaksha, Dinesh Saravana, Kumar S Sararvana, Gupta Mohit, Eisenhuth Gabriel, Eisenhuth Sebastian, Eisenhuth Claudia, Bhandi Shilpa
Аннотация
OBJECTIVE: Orthodontic treatments often involve the use of metal or ceramic brackets bonded to the enamel surface of teeth, which can increase the risk of developing white spot lesions (WSLs) (demineralization) due to prolonged exposure to plaque and bacterial acids. This study aimed to investigate the potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in promoting remineralization and minimizing enamel loss without compromising the bond strength of metal and ceramic brackets.
MATERIALS AND METHODS: This in vitro experimental study involves a total of 44 therapeutically extracted first premolars immersed in artificial saliva and subjected to periodic demineralization cycles. Among these, 11 premolars were treated with a CPP-ACP remineralizing agent bonded with metal brackets, while another 11 premolars were treated with a CPP-ACP remineralizing agent and bonded with ceramic brackets. The remaining premolars were bonded with metal brackets (n = 11) or ceramic brackets (n = 11) without CPP-ACP treatment. Scanning electron microscope (SEM) analysis was conducted after debonding the brackets.
RESULTS: One-way ANOVA revealed a statistically significant difference among groups (p < 0.0001). Group IV (ceramic brackets with CPP-ACP) had the highest number of samples with score 0 (90.9%), indicating complete surface remineralization. Group III (metal brackets with CPP-ACP) followed with a 72.72% score 0. In contrast, both control groups (I and II) had 81.81% score 3, indicating severe surface damage. Scanning electron microscope analysis corroborated these findings, with group IV showing a smoother, more uniform enamel surface.
CONCLUSION: The premolars treated with CPP-ACP and bonded with ceramic brackets exhibited significantly higher remineralization potential compared to those treated with CPP-ACP and bonded with metal brackets. How to cite this article: Anbarasu P, Bhattacharyya A, Dinesh S, et al. Evaluation of the Preventive Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on White Spot Lesions during Fixed Orthodontic Treatment Using Scanning Electron Microscopy. J Contemp Dent Pract 2025;26(11):1087-1091.
MATERIALS AND METHODS: This in vitro experimental study involves a total of 44 therapeutically extracted first premolars immersed in artificial saliva and subjected to periodic demineralization cycles. Among these, 11 premolars were treated with a CPP-ACP remineralizing agent bonded with metal brackets, while another 11 premolars were treated with a CPP-ACP remineralizing agent and bonded with ceramic brackets. The remaining premolars were bonded with metal brackets (n = 11) or ceramic brackets (n = 11) without CPP-ACP treatment. Scanning electron microscope (SEM) analysis was conducted after debonding the brackets.
RESULTS: One-way ANOVA revealed a statistically significant difference among groups (p < 0.0001). Group IV (ceramic brackets with CPP-ACP) had the highest number of samples with score 0 (90.9%), indicating complete surface remineralization. Group III (metal brackets with CPP-ACP) followed with a 72.72% score 0. In contrast, both control groups (I and II) had 81.81% score 3, indicating severe surface damage. Scanning electron microscope analysis corroborated these findings, with group IV showing a smoother, more uniform enamel surface.
CONCLUSION: The premolars treated with CPP-ACP and bonded with ceramic brackets exhibited significantly higher remineralization potential compared to those treated with CPP-ACP and bonded with metal brackets. How to cite this article: Anbarasu P, Bhattacharyya A, Dinesh S, et al. Evaluation of the Preventive Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on White Spot Lesions during Fixed Orthodontic Treatment Using Scanning Electron Microscopy. J Contemp Dent Pract 2025;26(11):1087-1091.