Department of Orthodontics, Odense Central Clinic, Tandplejen Grønløkkevej 30, DK-5000 Odense C, Denmark.
Clin Oral Investig. 2011 Jun;15(3):369-73. doi: 10.1007/s00784-010-0401-2. Epub 2010 Apr 10.
This study aims to investigate the effect of topical applications of 10% casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSL) detected after treatment with fixed orthodontic appliances. Sixty healthy adolescents with ≥1 clinically visible WSL at debonding were recruited and randomly allocated to a randomised controlled trial with two parallel groups. The intervention group was instructed to topically apply a CPP-ACP -containing agent (Tooth Mousse, GC Europe) once daily and the subjects of the control group brushed their teeth with standard fluoride toothpaste. The intervention period was 4 weeks and the endpoints were quantitative light-induced fluorescence (QLF) on buccal surfaces of the upper incisors, cuspids and first premolars and visual scoring from digital photos. The attrition rate was 15%, mostly due to technical errors, and 327 lesions were included in the final evaluation. A statistically significant (p < 0.05) regression of the WSL was disclosed in both study groups compared to baseline, but there was no difference between the groups. The mean area of the lesions decreased by 58% in the CPP-ACP group and 26% in the fluoride group (p = 0.06). The QLF findings were largely reflected by the clinical scores. No side effects were reported. Topical treatment of white spot lesions after debonding of orthodontic appliances with a casein phosphopeptide-stabilised amorphous calcium phosphate agent resulted in significantly reduced fluorescence and a reduced area of the lesions after 4 weeks as assessed by QLF. The improvement was however not superior to the "natural" regression following daily use of fluoride toothpaste.
本研究旨在探讨局部应用 10%酪蛋白磷酸肽-无定形磷酸钙（CPP-ACP）对固定正畸矫治器治疗后出现的白斑（WSL）的影响。招募了 60 名健康青少年，在脱粘时至少有 1 个临床可见的 WSL，并将其随机分配到一个随机对照试验的两个平行组中。干预组被指示每天局部应用含有 CPP-ACP 的制剂（Tooth Mousse，GC Europe），而对照组的受试者用标准含氟牙膏刷牙。干预期为 4 周，终点为上颌切牙、尖牙和第一前磨牙颊面的定量光诱导荧光（QLF）和数字照片的视觉评分。失访率为 15%，主要是由于技术错误，最终评估包括 327 个病变。与基线相比，两组的 WSL 均显示出统计学上的显著（p<0.05）回归，但两组之间没有差异。CPP-ACP 组病变的平均面积减少了 58%，氟组减少了 26%（p=0.06）。QLF 的发现与临床评分基本一致。未报告不良反应。在正畸矫治器脱粘后，用酪蛋白磷酸肽稳定的无定形磷酸钙制剂局部治疗白斑，4 周后通过 QLF 评估，荧光明显减少，病变面积减少。然而，这种改善并不优于每日使用含氟牙膏的“自然”消退。
