Anti-caries effect of CPP-ACP in irradiated nasopharyngeal carcinoma patients

Christina P. C. Sim, Joseph Wee, Ying Xu, Yin-Bun Cheung, Yoke-Lim Soong, David J. Manton
2014 Clinical Oral Investigations  
Objective: Determine the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on caries progression in irradiated nasopharyngeal carcinoma (NPC) patients. Methods: 21 males and 3 females (median age: 50 years) were randomized into two groups before radiotherapy. Subjects had at least eight teeth after oral health clearance. The test group used 0.4% stannous fluoride gel and a crème containing 10% CPP-ACP daily; the control group used a similar crème without CPP-ACP and
more » ... identical care. Subjects applied the crème three-times-daily and fluoride gel once daily. Caries status, saliva and plaque parameters were measured pre-radiotherapy, at 2-weeks and 3months post-radiotherapy. Results: Baseline ICDAS scores were: 0-1126 surfaces (93.9%); 1-28 surfaces (2.3%); 2-40 surfaces (3.3%); 3-6 surfaces (0.5%) for the control; and 0-1186 surfaces (95.6%); 1-31 surfaces (2.5%); 2-15 surfaces (1.2%); 3-8 surfaces (0.7%) for the test group. 22 subjects returned at 3-month post-radiotherapy with reduced plaque pH, salivary flow, pH and buffering capacity. 9 test and 8 control subjects developed 32 and 59 new caries lesions respectively. Test subjects showed lower caries progression than the controls: all surfaces (OR: 0.51, 95% CI: 0.17~1.59), occlusal (OR: 0.20, 95% CI: 0.03~1.29) and smooth surfaces (OR: 0.61, 95% CI: 0.16~2.38). The difference was not statistically significant. Conclusion: Application of CPP-ACP did not significantly reduce caries progression in NPC patients in the first three months after radiotherapy as compared to controls. Clinical relevance: Adjunct use of CPP-ACP with stannous fluoride gel in irradiated NPC patients gave comparable results compared to stannous fluoride gel alone in reducing caries progression.
doi:10.1007/s00784-014-1318-y pmid:25261399 fatcat:s2fj2xgg3zamdk6gpb7y4kstt4