Remineralizing potential of CPP-ACP creams with and without fluoride in artificial enamel lesions

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This study evaluated the effect of pastes containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) with and without fluoride on enamel demineralization.


Human enamel blocks were used and after incipient caries-like lesions were formed, they were assigned to four groups: G1 – saliva; G2 – MI Paste (RecaldentTM); G3 – MI Paste Plus (RecaldentTM 900 ppm as NaF); and G4 – Crest™ (1.100 ppm as NaF). The specimens were soaked in demineralizing solution for 6 hours and remineralized in artificial saliva for 18 hours alternatively for 10 days. The dentifrice was prepared with deionized water in a 1:3 proportion (w/w) or applied undiluted in the case of the CPP-ACP formula. Demineralized enamel changes were analysed by surface microhardness (SMH), 3D-profilometry and SEM. Data were analysed by non-parametric Kruskal–Wallis and Mann–Whitney test comparisons and one-way ANOVA and Tukey's HSD post hoc test (α = 0.05).


The SMH values observed in the G2 (47.8 ± 28.5) and G3 (53.6 ± 27.6) groups were different from that of G4 (90.2 ± 17.1), which were significantly higher than that found in G1 (39.4 ± 14.2). The %SMH was significantly lower in G4 when compared to G1 (p < 0.001) and G3 (p < 0.05).


MI Paste Plus demonstrated a greater protective effect against demineralization than MI Paste and showed smoother surfaces.

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