Title: 0217 - Anticariogenicity of a Saliva Biomimetic in Irradiated Head-and-neck Cancer Patients


Christina Sim (Presenter)
National Dental Centre Singapore

Glenn Walker, University of Melbourne
David Manton, University of Melbourne
Yoke-Lim Soong, National Cancer Centre Singapore
Joseph Wee, National Cancer Centre Singapore
Eric Reynolds, University of Melbourne


Objectives: The aim of this study was to investigate treatment with the saliva biomimetic, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and sodium fluoride/stannous fluoride (NaF/SnF2) compared with NaF/SnF2 alone on coronal surface caries progression in head-and-neck cancer patients undergoing radiotherapy.

Methods: Twenty-four study participants were randomised into two groups before radiotherapy. Both groups used a 0.32% NaF toothpaste and 0.4% SnF2 gel; the test group also applied a crème containing 10% CPP-ACP three times daily whilst the control group used an identical crème without CPP-ACP (placebo). Resting saliva flow rate and fluoride concentration were assessed before radiotherapy (baseline); mid-radiotherapy, two- and 12-weeks post-radiotherapy. Caries status was assessed using ICDAS II at baseline and 12-weeks post-radiotherapy. Data were statistically analysed using a linear mixed model and a z-test for comparison of proportions.

Results: Both groups showed significantly reduced resting saliva flow rate (p<0.001) 12 weeks post-radiotherapy. There were no significant differences in flow rates and fluoride concentration between the groups at any of the time points. For the placebo group, 59 (4.9% of total) surfaces [14 occlusal (5.8%) and 45 smooth (4.7%) surfaces] exhibited caries progression, whilst only 32 (2.6%) surfaces [3 occlusal (1.2%) and 29 smooth (2.9%) surfaces] in the CPP-ACP group showed progression. The CPP-ACP group exhibited a significant (p = 0.003) 47% reduction in total surfaces caries progression, a significant (p = 0.037) 38% reduction in smooth surfaces caries progression and a significant (p = 0.005) 79% reduction in occlusal surfaces caries progression compared with the placebo group 12 weeks post-radiotherapy.

Conclusions: Resting salivary flow rate was significantly reduced in head-and-neck cancer patients following radiotherapy and use of the saliva biomimetic CPP-ACP with NaF/SnF2 significantly lowered occlusal and smooth surfaces caries progression compared with NaF/SnF2 alone in these patients 12 weeks post-radiotherapy.

Student Presenter

This abstract is based on research that was funded entirely or partially by an outside source:
Dr C Sim is a recipient of an NMRC Research Training Fellowship. The study was supported by the NDCS Research Fund/NMRC Centre Grant

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE