| Summary: | AbstractAimTo assess the effectiveness of CPP-ACP in combination with daily fluoride use versus daily fluoride use alone on remineralization of early carious lesions in randomized controlled trials (RCTs).Material and methodsA systematic literature search was conducted following the PRISMA 2009 statement. The literature obtained from the searches in electronic databases were reviewed individually by two reviewers and the relevant titles and abstracts were selected with specific inclusion and exclusion criteria. The search was limited to articles published in English. Only randomized controlled clinical trials (RCTs) in which CPP-ACP was delivered by cream form were selected. The included studies were assessed for risk of bias and quality.Results The initial search carried out on PubMed and the Cochrane Library for publications up to January 2018 resulted in 267 scientific articles. Six randomized controlled trials (RCTs) were met the inclusion and exclusion criteria and were selected as eligible studies. Out of six studies in this review, three studies were judged to have a low risk of bias, one study was classified as moderate risk of bias and two studies were high risk of bias. No specific adverse effect related to CPP-ACP usage was observed. Conclusions Based on the literature, there is a tendency towards the benefits of CPP-ACP usage in addition to fluoride toothpaste and/or mouth rinse compared to fluoride toothpaste and/or mouth rinse alone on regression of early carious lesions. However, further well-designed long term clinical trials are required to establish this therapeutic strategy in the main stream clinical practice.
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