Efficacy of CPP-ACP and CPP-ACPF on enamel remineralization - an in vitro study using scanning electron microscope and DIAGNOdent

Indian J Dent Res. 2011 Jan-Feb;22(1):77-82. doi: 10.4103/0970-9290.80001.


Introduction: Remineralization as a treatment procedure has received a lot of attention both from clinicians as well researchers. The objective of this in vitro study was to find out the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) in remineralizing enamel surface on which artificial caries lesion had been created. The changes were analyzed using DIAGNOdent (KaVo) and scanning electron microscope (SEM).

Materials and methods: Ninety maxillary premolars were selected and divided into three groups of 30 teeth each: A (artificial saliva), B (CPP-ACP), and C (CPP-ACPF). All the samples were assessed using DIAGNOdent at the baseline and after demineralization and remineralization. Three samples were randomly selected from each group after remineralization for surface evaluation using SEM.

Results: Statistical analysis showed that group B {CPP-ACP (4.1 ± 1.8)} and group C {CPP-ACPF (4.8 ± 1.2)} had a significantly higher amount of remineralization than group A (1.7 ± 0.7).

Conclusion: All the three groups showed a statistically significant amount of remineralization. However, because of the added benefit of fluoride (NaF 0.2%), CPP-ACPF (Tooth Mousse-Plus) showed marginally more amount of remineralization than CPP-ACP (Tooth Mousse).

MeSH terms

  • Bicuspid
  • Cariostatic Agents / administration & dosage*
  • Caseins / administration & dosage*
  • Dental Caries Activity Tests
  • Dental Enamel / drug effects*
  • Dental Enamel / ultrastructure
  • Drug Combinations
  • Fluorides, Topical / administration & dosage*
  • Humans
  • Maxilla
  • Tooth Demineralization / drug therapy*
  • Tooth Demineralization / pathology
  • Tooth Remineralization / methods*


  • Cariostatic Agents
  • Caseins
  • Drug Combinations
  • Fluorides, Topical
  • casein phosphopeptide-amorphous calcium phosphate nanocomplex