| Name of the Calcium Phosphate Phases Including Abbreviations | In vivo Studies | In situ Studies |
|---|---|---|
| Hydroxyapatite (HAP), Ca5(PO4)3(OH) |
Kani et al. [58] Aim: Analysis of the anti-caries effects of a hydroxyapatite toothpaste compared to a placebo toothpaste Methods: DMFT-indices Outcome: HAP reduces caries within a cohort of Japanese schoolchildren |
Kensche et al. [45] Aim: Analysis of hydroxyapatite particles in oral biofilm management Methods: DAPI and live/dead staining, SEM Outcome: HAP particles reduce initial biofilm formation on enamel surfaces comparable to chlorhexidine |
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Makeeva et al. [59] Aim: Analysis of caries resistance of tooth enamel and teeth sensitivity after using a hydroxyapatite-toothpaste Methods: Assessment of enamel remineralization rate, dynamics of enamel acid resistance and teeth sensitivity Outcome: HAP remineralized enamel and led to an increased acid resistance |
Hannig et al. [57] Aim: Analysis of a hydroxyapatite mouthwash in oral biofilm management Methods: DAPI and live/dead staining Outcome: HAP-containing mouthrinse reduces initial biofilm formation comparable to chlorhexidine |
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Harks et al. [60] Aim: Analysis of a hydroxyapatite-toothpaste in periodontitis patients Methods: Plaque formation rate, plaque control record, gingival index, bleeding on probing, pocket probing depth Outcome: HAP toothpaste improves periodontal health |
Najibfard et al. [35] Aim: Analysis of the potential of a hydroxyapatite toothpaste in the remineralization of early caries lesions Methods: Microradiography Outcome: HAP remineralizes initial caries lesions comparable to fluoride |
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Lelli et al. [46]: Aim: Analysis of the potential of a hydroxyapatite toothpaste in remineralization of enamel Methods: SEM, TEM, EDX, XRD Outcome: HAP builds a protective layer on the enamel surface |
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Hegazy et al. [62] Aim: Analysis of a hydroxyapatite mouthwash in controlling plaque accumulation, gingivitis and remineralization Methods: Plaque and gingival indices, DIAGNOdent Outcome: HAP reduces plaque and gingival index and remineralizes early caries lesions |
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| β-tricalcium phosphate (β-TCP), β-Ca3(PO4)2 |
Vogel et al. [65] Aim: Analysis of calcium phosphate concentrations in plaque, plaque fluid and saliva Methods: Analysis of pH, free and total calcium, total phosphate Outcome: Deposition of calcium in the plaque and saliva after using β-TCP chewing gum |
None |
| Amorphous calcium phosphate (ACP), Cax(PO4)y ∙ n H2O |
Li et al. [73] This review shows that CPP-ACP has a significant remineralizing effect |
Lussi & Ganss [17] In this overview, the authors state CPP-ACP to be as effective as low-concentrated fluorides (cosmetic use) and less effective than high concentrated fluorides in preventing and remineralizing eroded lesions |
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Pukallus et al. [74] Aim: Analysis of a CPP-ACP cream in reducing mutans streptococci colonization and prevent early childhood caries Methods: Reduction in mutans streptococci colonization Outcome: CPP-ACP reduces mutans streptococci with 24 month old children, but not the caries prevalence |
Wiegand & Attin [80] Aim: Analysis of the effect of milk and CPP-ACP pastes on erosion Methods: Profilometry Outcome: CPP-ACP is not effective in reducing enamel and dentine loss |
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Hedge et al. [76] Aim: Comparison of salivary flow rate, pH and buffering capacity before/after chewing a CPP-ACP gum Methods: Collection of unstimulated and stimulated saliva; analysis of salivary flow rate, pH, and buffering capacity Outcome: CPP-ACP used in chewing gums increases salivary buffer capacity compared to a chewing gum without |
Meyer-Lückel et al. [81] Aim: Evaluate the remineralizing potential of a fluoride-free CPP-ACP-containing cream after the use of a fluoride-toothpaste compared to the prolonged use of a fluoride-toothpaste Methods: Transversal microradiography Outcome: CPP-ACP is less effective in remineralizing caries lesions compared to prolonged application of fluoride toothpaste |
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Vlacic et al. [77] Aim: Management and treatment of root caries Methods: Laser fluorescence Outcome: This case report shows CPP-ACP to be effective in stabilizing root caries lesions |
Kensche et al. [82] Aim: Influence of calcium phosphate based products on erosion Methods: Quantitative analysis of calcium and phosphate, SEM, TEM Outcome: Improvement of erosion protective properties using CPP-ACP was not as high as with fluorides |
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Yengopal et al. [83] This systematic review shows short-term remineralizing effects and caries preventing long-term effects |
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Bailey et al. [78] Aim: Effects of a remineralizing cream in post-orthodontic subjects Methods: ICDAS II Outcome: Regression of white spot lesions (ICDAS II code 2 and 3) compared to placebo (31%) |
Shen et al. [79] Aim: Analysis of the potential of calcium phosphate based products to remineralize enamel lesions Methods: Quantitative analysis of calcium, phosphate and fluoride; transverse microradiography Outcome: Enamel lesion remineralization of CPP-ACP was significantly higher compared to placebo, 1000 ppm fluoride and 5000 ppm fluoride; highest remineralization was identified with a combination of CPP-ACP and 900 ppm fluoride |
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| Calcium phosphosilicate (CSPS), 45% SiO2, 24.5% CaO, 24.5% Na2O, 6% P2O5 |
Tai et al. [89] Aim: Analysis of anti-gingivitis and anti-plaque effects of a bioactive glass-containing toothpaste Methods: Plaque index, gingival bleeding index Outcome: Bioactive glass-containing toothpaste significantly reduces gingival bleeding and supragingival plaque compared to a placebo |
Parkinson et al. [94] Aim: Investigate the effect of CSPS alone and in addition with SMFP on the enamel remineralization Methods: Surface microhardness (Knoop hardness) Outcome: CSPS and SMFP have both the same cariostatic effect |
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Parkinson et al. [95] Aim: Elucidate potential interactions of CSPS on the efficacy of SMFP to promote remineralization Methods: Surface microhardness and transverse microradiography Outcome: CSPS has the same remineralizing effect as fluoride (SMFP) and does not improve the cariostatic effect of SMFP |
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| Calcium glycerophosphate (CGP), C3H7CaO6P |
Bowen et al. [99] Aim: Test the caries activity after addition of CGP to the diet of monkeys Methods: 11 monkeys received a carbohydrate-rich-diet. 5 monkeys were additionally fed with 1% CGP within the diet. After 30 months, carious lesions were identified Outcome: CGP as monkey diet addition shows a significantly cariostatic effect compared to no intervention |
None |
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Brook et al. [100] Aim: Determine the calcium and phosphate concentration in dental plaque after consuming milk cereal tablets with 1% CGP Methods: 14 children consumed 4 times a day for 3 months tablets with 1% CGP. Before, in between and after the study plaque samples were analyzed Outcome: No increase in calcium-levels in the plaque |
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Edgar et al. [105] Aim: Identify the anti-caries effect of CGP Methods: 8 volunteers rinsed for 18 days with 50% sucrose solution (9 times daily for 2 min.). Half of the time (9 days) CGP (1%) was added to the solution. After this study period, NaF (2%) was topically applied Outcome: Neither CGP nor 2% fluoride application were able to inhibit demineralization of teeth that were not cleaned for 18 days and exposed to sucrose |
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Wycoff et al. [102] Aim: Effect of mouthrinses with CGP on the amount and chemical composition of dental plaque Methods: 60 children between 13 and 16 years of age were separated into three groups: 10 mL of mouthrinse twice daily with (i) 0,5% CGP, (ii) 1,5% CGP and (iii) placebo. Duration: 8 weeks. Analysis of plaque weight and chemical composition Outcome: CGP as mouthrinse shows increased phosphate in the plaque |