Casein Phosphopeptide- Amorphous Calcium Phosphate in Dentistry: A Literature Review

Öz

Casein is a phosphoprotein in bovine milk and accounts for almost 80 percent of its total protein. Casein fosfopeptit (CPP) is produced as a result of decomposition of casein with trypsin enzyme using a selective deposition method. CPP can remarkably stabilize calcium phosphate in a state-forming CPPamorphous calcium phosphate (ACP) complex. CPPACP is located in topical gels, sugar-free chewing gum and mint dragees at the present day. In this paper, the effectiveness of CPP-ACP and usage in dentistry are presented with a wide review of the literature.

Anahtar Kelimeler

• CPP-ACP, dentistry

Diş Hekimliğinde Kazein Fosfopeptit Amorf Kalsiyum Fosfat: Bir Literatür Derlemesi

Öz

Kazein, süt proteinlerinin yaklaşık %80’ini oluşturan bir fosfoproteindir. Kazein fosfopeptit ise (CPP), seçici çökelme yöntemi kullanarak kazeinin tripsin enzimi ile parçalanması sonucunda elde edilir. CPP, kalsiyum fosfatı CPP-amorf kalsiyum fosfat (ACP) kompleksi şeklinde stabilize edebilir. CPP-ACP, günümüzde topikal jeller, şekersiz sakızlar ve naneli drajeler içinde bulunmaktadır. Bu yazıda CPP-ACP’nin etkinliği ve diş hekimliğinde kullanım alanları geniş bir literatür derlemesi ile sunulmuştur.

Anahtar Kelimeler

• CPP-ACP, diş hekimliği

Kaynakça

1. Azarpazhooh A, Limeback H. Clinical efficacy of casein derivatives: a systematic review of the literature. J Am Dent Assoc 2008; 139: 915-24.
2. Çelik EU, Yazkan B, Katırcı G. Başlangıç çürük lezyonlarının tedavisi. Atatürk Üniv Diş Hek Fak Derg 2011; 21: 48-56.
3. Çetin B, Avşar A, Ulusoy AT. Kazein içerikli besinler ve dental ürünler. Atatürk Üniv Diş Hek Fak Derg 2011; 4: 24-31.
4. Aimutis WR. Bioactive properties of milk proteins with particuler focus on anticariogenesis. J Nutr 2004; 134: 989-95.
5. Cross K J, Huq NL, Palamara JE, Perich JW, Reynolds EC. Physicochemical characterization of casein phosphopeptide-amorphous calcium phosphate nanocomplexes. J Biol Chem 2005; 280: 15362–9.
6. Keleş K. Mine yüzeyindeki beyaz lezyonların “CPPACP” ile remineralizasyonu sonrası braket bağlanma dayanımlarının incelenmesi: in vitro çalışma. Çukurova Üniversitesi Sağlık Bilimleri Enstitüsü Ortodonti Anabilim Dalı, Doktora Tezi, Adana 2010.
7. Shaw JH. Effects of dietary composition on tooth decay in the albino rat. J Nutr 1950; 41: 13-24.
8. Reynolds EC, Riley PF, Adamson NA. Selective precipitation purification procedure for multiple phophoseryl-containing peptides and methods for their identification. Analytic Biochem 1994; 217: 277Reynolds EC. Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review. Spec Care Dentist 1998; 18: 8-16.

9. Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC. Remineralization of enamel subsurface lesions by sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. J Dent Res 2001; 80: 2066-70.
10. Reynolds EC. Casein phosphopeptide-amorphous calcium phosphate: the scientific evidence. Adv Dent Res 2009; 21: 25-9.
11. Reynolds EC, Cain CJ, Webber EL, Black CL, Riley PF, Johnson IH, Perich JW. Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res 1995; 74: 1272Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptidestabilized calcium. J Dent Res 1997; 76: 1587-95.
12. Rose RK. Efects of an anticariogenic casein phosphopeptide on calcium difusion in streptococcal model dental plaques. Arch Oral Biol 2000; 45: 569-75.
13. Morgan MV, Adams GG, Bailey DL, Tsao CE, Fischman SL, Reynolds EC. The anticariogenic effect of sugar-free gum containing cpp-acp nanocomplexes on approximal caries determined using digital bitewing radiography. Caries Res 2008; 42: 171–84.
14. Reynolds EC. Casein phosphopeptide-amorphous calcium phosphate and the remineralization of enamel. Us Dentistry 2006; 51-4.
15. Iijima Y, Cai F, Shen P, Walker G, Reynolds C, Reynolds EC. Acid resistance of enamel subsurface lesions remineralized by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. Caries Res 2004; 38: 551-6.
16. Rahiotis C, Vougiouklakis G. Effect of a CPP-ACP agent on the demineralization and remineralization of dentine in vitro. J Dent 2007; 35: 695-8.
17. Cochrane NJ, Saranathan S, Cai F, Cross KJ, Reynolds EC. Enamel subsurface lesion remineralisation with casein phosphopeptide stabilised solutions of calcium, phosphate and fluoride. Caries Res 2008; 42: 88–97.
18. Jayarajan J, Janardhanam P, Jayakumar P, Deepika. Efficacy of CPP-ACP and CPP-ACPF on enamel remineralization - an in vitro study using scanning electron microscope and DIAGNOdent®. Indian J Dent Res 2011; 22: 77-82.
19. Zhang Q, Zou J, Yang R, Zhou X. Remineralization effects of casein phosphopeptide-amorphous calcium phosphate crème on artificial early enamel lesions of primary teeth. Int J Paediatr Dent 2011; 21: 374-81.
20. Hamba H, Nikaido T, Inoue G, Sadr A, Tagami J. Effects of CPP-ACP with sodium fluoride on inhibition of bovine enamel demineralization: a quantitative assessment using micro-computed tomography. J Dent 2011; 39: 405-13.
21. Clarkson BH, Feagin FF, McCurdy SP, Sheetz JH, Speirs R. Effects of phosphoprotein moieties on the remineralization of human root caries. Caries Res 1991; 25: 166-73.
22. Şahin ES. Başlangıç mine lezyonlarının tedavisinde florid ilave edilmiş kazein fosfopeptit amorf kalsiyum fosfat (CPP-ACPF) ile floridli süt ve suyun etkinliğinin araştırılması. Ankara Üniversitesi Sağlık Bilimleri Enstitüsü Pedodonti Anabilim Dalı, Doktora Tezi, Ankara 2011.
23. Reynolds EC, Cai F, Cochrane NJ. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res 2008; 87: 344-8.
24. Srinivasan N, Kavitha M, Loganathan SC. Comparison of the remineralization potential of CPP–ACP and CPP–ACP with 900 ppm fluoride on eroded human enamel: an in situ study. Arch Oral Biol 2010; 55: 541-4.
25. Rahiotis C, Vougiouklakis G, Eliades G. Characterization of oral films formed in the presence of a CPP–ACP agent: An in situ study. J Dent 2008; 36: 272-80.
26. Caruana PC, Mulaify SA, Moazzez R, Bartlett D. The effect of casein and calcium containing paste on plaque pH following a subsequent carbohydrate challenge. J Dent 2009; 37: 522-6.
27. Ehrlich H, Petros G, Konstantinos D. Principles of demineralization: modern strategies for the isolation of organic frameworks: Part I. Common definitions and history. Micron 2008; 39: 1062–91.
28. Hermann E, Petros G, Konstantinos D. Principles of demineralization: modern strategies for the isolation of organic frameworks: Part II. Decalcification. Micron 2009; 40: 169–93.
29. Kazuo Onumaa KY, Ayako O. Nucleation and growth of hydroxyapatite nanocrystals for nondestructive repair of early caries lesions. J Cryst Growth 2005; 282: 199–207.
30. Arends J, Christoffersen J. The nature of early caries lesions in enamel. J Dent Res 1986;65:2-11.
31. Elsayad I, Sakr A, Badr Y. Combining casein phosphopeptide-amorphous calcium phosphate with fluoride: synergistic remineralization potential of artificially demineralized enamel or not? J Biomed Opt 2009; 14: 4439-56.
32. Mathias J.Kavitha S, Mahalaxmi S. A comparison of surface roughness after micro abrasion of enamel with and without using CPP-ACP: An in vitro study 200 Ranjitkar S, Rodriguez JM, Kaidonis JA, Richards LC, Townsend GC, Bartlett DW. The effect of casein phosphopeptide–amorphous calcium phosphate on erosive enamel and dentine wear by toothbrush abrasion. J Dent 2009; 37: 250-4.
33. Panich M, Poolthong S. The effect of casein phosphopeptide-amorphous calcium phosphate and a cola soft drink on ın vitro enamel hardness. JADA 2009; 140: 455-60.
34. Kallayathi U, Panich M, Poolthong S. Preventive effect of CPP–ACP paste on enamel erosion in vitro. J Dental 2009; 11: 101-3.
35. Vongsawan K, Surarit R, Rirattanapong P. The effect of high calcium milk and casein phosphopeptide-amorphous calcium phosphate on enamel erosion caused by cholinated water. Southeast Asian J Trop Med Public Health 2010; 41: 1494-9.
36. Singh RD, Ram SM, Shetty O, Chand P, Yadav R. Efficacy of casein phosphopeptide-amorphous calcium phosphate to prevent stain absorption on freshly bleached enamel: an in vitro study. J Conserv Dent 2010; 13: 76-9.
37. Bröchner A, Christensen C, Kristensen B, Tranæus S, Karlsson L, Sonnesen L, Twetman S. Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate. Clin Oral Invest 2011; 15: 369–73.
38. Mayne RJ, Cochrane NJ, Cai F, Woods MG, Reynolds EC. In-vitro study of the effect of casein phosphopeptide amorphous calcium fluoride phosphate on iatrogenic damage to enamel during orthodontic adhesive removal. Am J Orthod Dentofacial Orthop 2011; 139: e543-51
39. Al Zraikata H, Palamara JEA, Messer HH, Burrow MF, Reynolds EC. The incorporation of casein phosphopeptide–amorphous calcium phosphate into a glass ionomer cement. Dent Mater 2011; 27: 235Wong RH, Palamara JE, Wilson PR, Reynolds EC, Burrow MF. Effect of CPP–ACP addition on physical properties of zinc oxide non-eugenol temporary cements. Dent Mater 2011; 27: 329-38.
40. Reynolds EC, Cai F, Shen P, Walker GD. Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugarfree chewing gum. J Dent Res 2003; 82: 206-11.
41. Manıkandan P, Ventatachalam M, Kumar RRR. Oral health: Role of chewing gum. Brunei Int Med J 2011; 7: 130-8.
42. Schirrmeister JF, Seger RK, Altenburger MJ, Lussi A, Hellwig E. Effects of Various Forms of Calcium Added to Chewing Gum on Initial Enamel Carious Lesions in situ. Caries Res 2007; 41: 108–114.
43. Cai F, Manton DJ, Shen P, Walker GD, Cross KJ, Yuan Y, Reynolds C, Reynolds EC. Effect of Addition of Citric Acid and Casein PhosphopeptideAmorphous Calcium Phosphate to a Sugar-Free Chewing Gum on Enamel Remineralization in situ. Caries Res 2007; 41: 377–83 Yazışma Adresi: Yrd. Doç. Dr. Çiğdem GÜLER
44. Ordu Üniversitesi Diş Hekimliği Fakültesi Pedodonti Anabilim Dalı 52200 Ordu Telefon: [phone] e-mail: [e-mail]