Remineralization of Enamel Subsurface Lesions by Casein Phosphopeptide-stabilized Calcium Phosphate Solutions

Casein phosphopeptides (CPP) stabilize amorphous calcium phosphate (ACP), localize ACP in dental plaque, and are anticariogenic in animal and in situ human caries models. In this in vitro study, CPP-stabilized calcium phosphate solutions were shown to remineralize subsurface lesions in human third-m...

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Bibliographic Details
Published in:Journal of dental research Vol. 76; no. 9; pp. 1587 - 1595
Main Author: Reynolds, E.C.
Format: Journal Article
Language:English
Published: Los Angeles, CA SAGE Publications 01.09.1997
SAGE PUBLICATIONS, INC
Subjects:
Calcium - chemistry
calcium phosphate
Calcium Phosphates - chemistry
Calcium Phosphates - therapeutic use
Cariostatic Agents - therapeutic use
casein phosphopeptides
Caseins - chemistry
Caseins - therapeutic use
Chemical Precipitation
Crystallography
Dental Enamel - drug effects
Dental Enamel - metabolism
Dental Enamel - ultrastructure
Durapatite - chemistry
enamel remineralization
Humans
Hydrogen-Ion Concentration
Microradiography
Microscopy, Electron, Scanning
Minerals - analysis
Molar, Third
Phosphates - chemistry
Phosphopeptides - chemistry
Phosphopeptides - therapeutic use
Photometry
Solubility
Solutions
Tooth Demineralization - drug therapy
Tooth Demineralization - metabolism
Tooth Demineralization - pathology
Tooth Remineralization - methods
calcium phosphate
casein phosphopeptides
enamel remineralization
ISSN:0022-0345, 1544-0591
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Summary:Casein phosphopeptides (CPP) stabilize amorphous calcium phosphate (ACP), localize ACP in dental plaque, and are anticariogenic in animal and in situ human caries models. In this in vitro study, CPP-stabilized calcium phosphate solutions were shown to remineralize subsurface lesions in human third-molar enamel. Solutions were used to examine the effect of CPP-calcium phosphate concentration on remineralization. Other solutions were used to examine the effect of increasing pH, which decreased the concentrations of free calcium and phosphate ions and increased the level of CPP-bound ACP. Although most of the remineralizing solutions were supersaturated with respect to the amorphous and crystalline calcium phosphate phases, the solutions were stabilized by the CPP such that spontaneous precipitation of calcium phosphate did not occur. After a ten-day remineralization period, enamel lesions were sectioned, subjected to microradiography, and the mineral content determined by microdensitometry. All solutions deposited mineral into the bodies of the lesions, with the 1.0% CPP-calcium phosphate (pH 7.0) solution replacing 63.9 ±20.1% of mineral lost at an averaged rate of 3.9 ± 0.8 x 10-8 mol hydroxyapatite/m2/s. The remineralizing capacity was greater for the solutions with the higher levels of CPP-stabilized free calcium and phosphate ions. Remineralization was not significantly correlated with either the CPP-bound ACP or the degrees of saturation for hydroxyapatite, octacalcium phosphate, or ACP. However, remineralization was significantly correlated with the degree of saturation for dicalcium phosphate dihydrate (CaHPO4.2H2O), but this was attributed to the significant correlation of remineralization with the activity gradients from the solution into the lesion of some calcium phosphate ions and ion pairs, in particular the neutral ion pair CaHPO4 0. The CPP, by stabilizing calcium phosphate in solution, maintain high-concentration gradients of calcium and phosphate ions and ion pairs into the subsurface lesion and thus effect high rates of enamel remineralization.
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ISSN:0022-0345
1544-0591
DOI:10.1177/00220345970760091101