Mechanism of Action/ Remineralization with CPP-ACP and CPP-ACFP

Question 1

What is the difference between CPP-ACP and CPP-ACFP

Answer 1

CPP-ACFP is casein phosphopeptide stabilised amophorous calcium fluoride phosphate

addition of f- *

Question 2

What can form in the mouth during a naF rinse besides HA and FA?

Answer 2

Fluorhydroxyapatite (FHA)

Question 3

Why does FHA form in the presence of fluoride rather than FA?

What is required in it’s formation?

Answer 3

due to in-situ oral environment, FA doesn’t usually form

HFA requires at least 10 Ca2+ and 6 PO4 3-

Question 4

Explain how casein phosphopeptides stabilize calcium and phosphate ions.

Answer 4

Negatively charged segments of Amino Acids (Ser, Glu, Ala) form binding motifs that wrap around positively calcium and phosphate ions

Question 5

What is recaldent?

Answer 5

casein phosphopeptide (CPP)

Question 6

What is a good ratio of CPP ACFP in regards to ionic conc?

Answer 6

5:3:1 , Ca:P:F

Question 7

What does CPP-ACP do? General.

Answer 7

1. Prevent Demin
2. Promote Remin
3. Alter biofilm

Question 8

What is the mechanism of action of CPP-ACP? Describe the “journey”

Answer 8

1) Stabilization of CA-P
2) Bind plaque via calcium cross-linking, H-bonding, or hydrophobic interactions
3) Release via Equilibrium Drive, Conformational, Ph Depedent, or enzymatic mechanisms

Question 9

Explain all the Release mechanisms for ACP CPP after binding onto plaque

Answer 9

1) Equilibrium of CPP/ACP causes release due to high [complex] and low [free ion]

2) Conformational release due to HA inducing conformational change in CPP

3) pH dependent: drop in ph decreases net negative charge of cpp, release calcium ions due to lowered holding strength

4) Enzymatic releasephatases cleave phosphoepeptides and release ca P

Question 10

How does CPP ACP inhibit demin?

Answer 10

1) Bind HA and act as a physical barrier to dissolution

2) CPP and Phosphate buffer pH - CPP’s phosphoseryl and glutamyl residues accept protons and bacteria degredation of casein/CPP produce ammonia

3) increase [ca][po4] increases IAP to inhibit undersat

4) change microbial composition

Question 11

How does CPP ACP promote remineralization?

Answer 11

Model 1: Neutral ion theory
Model 2: Complex theory

Question 12

CPP-ACP combined with Fluoride creates a beneficial additive effect

True or False

Answer 12

False

CPP-ACP and Fluoride is synergistic

Question 13

CPP-ACP enhances fluoride uptake superficially and deep of enamel lesions

True or False

Answer 13

True

Question 14

How does CPP alter bacterial communities in dental plaque?

Answer 14

1) Mask specific receptors on the pellicle

2) Competitive binding of calcium to prevent ca bridging of bacterial cells

3) Binding bacterial surface to cause electrostatic repulsion

Question 15

What would you prefer to use after removing your braces:

Fluoride monotherapy

CPP-ACPF monotherapy

Defend your argument

Answer 15

CPP-ACPF