Erosion Protection Clinical Trial
Official title:
Impact of Milk and Casein Phosphopeptide-amorphous Calcium Phosphate on Erosion/Abrasion of Enamel and Dentin - an in Situ Study
This in situ study aims to investigate
- the protective potential of milk and fluoridated milk on erosive wear of enamel
- the protective potential of milk and fluoridated milk on erosive wear of dentin
- to compare to protective potential of milk and fluoridated milk with products
containing casein phosphopeptide-amorphous calcium phosphate
- to compare the protective potential of milk and fluoridated milk with a fluoridated
toothpaste or stannous-chloride containing fluoride solution (SnCl2/AmF/NaF)
Dental erosion is defined as the pathogenic, chronic, chemical removal of dental hard
tissues due to the frequent contact to extrinsic or intrinsic acids. The dissolution process
is determined by the pH, the chelating properties, mineral content and kind of acid, but in
the same time modified by various biological (e.g. saliva, pellicle) and behavioural
factors.
The anticariogenic properties of milk are widely investigated, but information of the
effects of milk or milk components on the development of erosion are limited. It is
suggested that the demineralisation process is reduced by the presence of calcium and
phosphate, but also that casein proteins affect the demineralisation by adsorbing to the
hydroxyapatite surface and inhibiting its dissolution. Initial studies suggest that milk is
able to increase rehardening of acid-softened enamel, but information about the effects of
milk on dentin erosion are not available yet. Particularly, the effect of fluoridated milk
on dental erosion was not investigated yet.
In contrast, recent studies analysed the effects of products containing casein
phosphopeptide-amorphous calcium phosphate (CPP-ACP) on erosion, as it is suggested that
CPP-ACP promotes a supersaturated state and increased remineralisation of demineralised
dental hard tissue. However, in situ studies on the effect of CPP-ACP on erosion are limited
to one study, which compared microhardness of enamel after treatment with CPP-ACP and
CPP-ACP and 900 ppm fluoride, but failed to use appropriate controls in form of other
products containing calcium and phosphate or fluoride. In summary, the effects of milk, in
particular fluoridated milk, and products containing milk proteins, such as casein
phosphopeptide-amorphous calcium phosphate, on erosive wear were not analysed in an
in-situ-model so far.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Outcomes Assessor)