Efficacy of casein derivate CPP-ACP1

OBJECTIVE: A literature review of systematic reviews and in situ and in vivo randomized controlled trials was conducted in order to assess the role of casein phosphopeptide - amorphous calcium phosphate in providing caries-preventive effect superior to any intervention or placebo. METHODS: Initially, Pubmed database was searched for systematic reviews. Two systematic reviews were identified, which concluded that the quantity and quality of randomized controlled trials were insufficient to recommend the clinical use of the product. After this, Pubmed database was searched for in situ and in vivo randomized controlled trials that were not included in the reviews identified. In vivo and in situ studies yielded mixed results. RESULTS: In situ studies indicated greater efficacy of casein phosphopeptide - amorphous calcium phosphate in comparison with placebo. Whereas, in vivo studies demonstrated different findings CONCLUSION: Casein phosphopeptide - amorphous calcium phosphate had a performance equivalent to or greater efficacy than placebo; fluoride was more effective than the casein complex; casein phosphopeptide - amorphous calcium phosphate associated with fluoride showed better or equivalent performance to that of placebo. In view of available evidence, it was not possible to generalize the indication of casein phosphopeptide - amorphous calcium phosphate for preventing dental caries. Further studies on the preventive effect and longer treatment applications are recommended.