ACP: Navigating our way through calcium phosphate technologies
By Lillian Caperila, RDH, MEd, Professional Educator with Premier Dental Products Company
Of all the technologies aimed at enhancing tooth remineralization, fluoride remains the most widely used and thoroughly studied drug of treatment of tooth decay. Several examples of calcium-containing technologies that provide remineralizing benefits include amorphous calcium phosphate and tri-calcium phosphate. (2)Research has shown that the rate of remineralization of enamel increases with the quantity of calcium and phosphate ions in a solution. (3) The role of loosely bound fluoride (calcium fluoride) found concentrated in plaque and saliva can supplement the demineralized tooth structure by providing an improved enamel crystal structure through the formation of acid-resistant, fluoride-rich hydroxyapatite (fluorapatite). This form of incorporated fluoride ion is known as firmly bound fluoride. (4) Amorphous calcium phosphate (ACP) was discovered by ADA Foundation Paffenbarger Research Center chemist and researcher, Ming S. Tung, PhD, in 1991. ACP is the first non-fluoride therapy to remineralize enamel and dentin. (5) The most reactive and soluble calcium phosphate compound, ACP forms on the tooth enamel and within the dentin and dentinal tubules, and also provides a reservoir of remineralizing ions in the saliva. The ACP-forming ingredients also strengthen teeth by acting synergistically to promote more fluoride uptake into the tooth structure as compared to similar fluoride products without ACP. Whereas, tri-calcium phosphate (TCP) formula through a manufacturing process of mechanochemical ball milling of tri-calcium phosphate with fumeric acid will form a barrier that inhibits the calcium from attaching to the fluoride ions. The barrier eventually will break down on the tooth surface and allow the calcium to be readily available. (6)
1. Papas A (1), Russell D (1), Singh M (1), Kent R (2), Triol C (3), Winston A (3). Caries clinical trial of a remineralising toothpaste in radiation patients(1) Tufts University School of Dental Medicine, Boston, MA, USA; (2) Forsyth Institute, Boston, MA, USA; (3) Independent Consultants Oral Medicine, Tufts University School of Dental Medicine, Boston, MA, USA2. A.M. Pfarrer and R.L. Karlinsey, “Challenges of implementing new remineralization technologies” Adv. Dent Res. 2009; 21:79 adr.sagepub.com.3. Schemehorn B.R., Orban J.C., Wood G.D., Fischer G.M., “Remineralization by fluoride enhanced with calcium and phosphate ingredients” J Clint Dent, 1997: 76 (Special Issue): 376.4. White, D J, Nancollas, G H, “Physical and chemical considerations of the role of firmly and loosely bound fluoride in caries prevention”, J Dent Res. 1990 Feb; 69 Spec No: 587-94. 5. Garvin J “ACP: the next big thing” ADA News. August 2007: 1, and 10.6. www.indianananotech.com/images/Clinpro_5000_Brochure.pdf7. Dental Product Testing, In. “Final Report, Sound Enamel Fluoride Uptake Study #10-251 Method #40SV”, November 1, 2010.
Lil Caperila, RDH, MEd