Anticariogenic efficacy of a saliva biomimetic in head-and-neck cancer patients undergoing radiotherapy

Background The aim of this study was to investigate the effect of treatment with the saliva biomimetic, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and SnF2/NaF compared with SnF2/NaF alone on coronal surface caries progression in head-and-neck cancer patients undergoing radiotherapy. Methods Twenty-four participants were randomized into two groups. Both groups used 0.4% SnF2 gel and a 0.32% NaF toothpaste; the test group also applied a creme containing 10% CPP-ACP three times daily while the control group used an identical creme without CPP-ACP (placebo). Resting saliva flow rate and saliva fluoride concentrations were determined. Caries status was assessed using ICDASII at baseline and 12-weeks postradiotherapy. Data were statistically analysed using a linear mixed effects model. Results Both groups showed significantly reduced resting saliva flow rate (P < 0.001) postradiotherapy. There were no significant differences in flow rates and fluoride concentration between groups. The CPP-ACP group exhibited a significant (P < 0.05) 51% reduction in coronal surface caries progression compared with the placebo group. Conclusion Resting salivary flow rate was significantly reduced in head-and-neck cancer patients following radiotherapy and use of CPP-ACP with SnF2/NaF significantly lowered caries progression compared with SnF2/NaF alone.