Juárez-López María Lilia Adriana, Hernández-Palacios Rosa Diana, Hernández-Guerrero Juan Carlos, Jiménez-Farfán Dolores, Molina-Frechero Nelly
Facultad de Estudios Superiores Zaragoza. Universidad Nacional Autónoma de México.
Rev Invest Clin. 2014 Mar-Apr;66(2):144-51.
INTRODUCTION. Dental caries continues to affect a large percentage of Mexican children and currently advises that if diagnosed at an early stage can be reversed with minimally invasive treatments. The casein phosphopeptide amorphous calcium phosphate known as CPP-ACP is a phosphoprotein capable of releasing calcium and phosphate ions in the oral environment promoting remineralization. OBJECTIVE. To evaluate the effect of CPP-ACP with fluoride added in a scholar preventive program. MATERIAL AND METHODS. A cuasi- experimental study was conducted in 104 schools of six years old. The children were classified into three groups and received six months biweekly applications of different treatments: casein phosphopeptide amorphous calcium phosphate added fluoride (CPP-ACPF), sodium fluoride (NaF) and a control group. Clinical evaluation was performed with the laser fluorescence technique (Diagnodent model 2095). 1340 teeth were included: 294 teeth with incipient lesions and 1,046 healthy teeth. Statistical tests of χ2 y Mc Nemar were used. RESULTS. In the group that received the application of CPP-ACPF, 38% of incipient carious lesions were remineralizing compared with 21% in the group receiving the NaF (p < 0.001) and 15% in the control group (p < 0.0001) The percentage of teeth free of caries were preserved in the therapy group phosphoprotein was the biggest. This group also showed the lower proportion of deep carious lesion development (p < 0.0001). CONCLUSION. The application biweekly for six months of CPP-ACPF showed a protective and remineralizing effect on incipient carious lesions. His action was better than the application of NaF. However, to reduce the impact from dental caries in schoolchildren is important to have a comprehensive preventive approach that includes promoting self-care, as well as the application of sealants.
引言。龋齿仍然影响着很大比例的墨西哥儿童，目前建议如果在早期阶段被诊断出来，可以通过微创治疗使其逆转。酪蛋白磷酸肽无定形磷酸钙（称为CPP-ACP）是一种磷蛋白，能够在口腔环境中释放钙离子和磷酸根离子，促进再矿化。目的。评估添加氟化物的CPP-ACP在一项学校预防计划中的效果。材料与方法。在104所六岁儿童学校进行了一项准实验研究。将儿童分为三组，每两周接受六个月的不同治疗：添加氟化物的酪蛋白磷酸肽无定形磷酸钙（CPP-ACPF）、氟化钠（NaF）和一个对照组。使用激光荧光技术（Diagnodent 2095型）进行临床评估。共纳入1340颗牙齿：294颗有早期病变的牙齿和1046颗健康牙齿。使用χ2和Mc Nemar统计检验。结果。在接受CPP-ACPF治疗的组中，38%的早期龋损正在再矿化，而接受NaF治疗的组为21%（p < 0.001），对照组为15%（p < 0.0001）。接受磷蛋白治疗组中无龋牙齿的百分比保持最高。该组中深度龋损发展的比例也最低（p < 0.0001）。结论。每两周应用六个月的CPP-ACPF对早期龋损显示出保护和再矿化作用。其效果优于NaF的应用。然而，要降低学龄儿童龋齿的影响，采取包括促进自我护理以及应用窝沟封闭剂在内的综合预防方法很重要。
