A COMPARATIVE EVALUATION OF THE NUMBER OF STREPTOCOCCUS MUTANS COLONIES IN THE ENAMEL SURFACE OF TEETH AFTER THE APPLICATION OF CPP-ACP CONTAINING PROPOLIS AND CPP-ACP WITHOUT PROPOLIS
Keywords:Casein phosphopeptide-amorphous calcium phosphate, Remineralization, White spot, Propolis, Streptococcus mutans
Objective: This study was to determine the efficacy of CPP-ACP combined with propolis by evaluating the number of Streptococcus mutans colonies in
the enamel surfaces of children aged 7–9 years before and after the application of CPP-ACP containing propolis.
Methods: A quasi-experimental pretest-posttest design with purposive sampling was used in this study, which was conducted on 32 students aged
7–9 years who were divided into two groups that were intervention and control groups. Two young dentists examined the students, and their results
were calibrated by a kappa value of 0.82. The number of S. mutans colonies was evaluated at baseline, and after a CPP-ACP propolis paste was applied
to white spot surfaces in the intervention group and CPP-ACP without propolis was applied to white spot surfaces of students in the control group in
every day for 4 weeks.
Results: There was a significant decrease in the proportion of S. mutans colonies both of the intervention group (28%) and the control group (26%)
(p<0.05). However, there was no significant difference in the effect of CPP-ACP propolis combination compared to CPP-ACP without propolis in
decreasing the number of S. mutans colonies (p>0.05).
Conclusion: This study confirmed that CPP-ACP containing propolis is not better than CPP-ACP without propolis in decreasing the number of S. mutans
colonies; however, the CPP-ACP propolis combination has the potential to be used as an alternative material to prevent demineralization and improve
remineralization of white spots in enamel surfaces.
sequence of fluoride and CPP-ACP on remineralization of white spot
lesions in primary teeth: An in-vitro study. Arch Oral Biol 2017;83:236-40.
2. Decker EM, Klein C, Schwindt D, Von Ohle C. Metabolic activity of
Streptococcus mutans biofilms and gene expression during exposure to
xylitol and sucrose. Int J Oral Sci 2014;6:195-204.
3. Parolia A, Thomas M. Propolis and its potential uses in oral health. Int
J Med Med Sci 2010;2:210-5.
4. Machorowska-Pieniazek A, Skucha-Nowak M, Mertas A,
Tanasiewicz M, Niedzielska I, Morawiec T, et al. Effects of brazilian
propolis on dental plaque and gingiva in patients with oral cleft
malformation treated with multibracket and removable appliances:
A comparative study. Evid Based Complement Alternat Med
5. Vanni R, Waldner-Tomic NM, Belibasakis GN, Attin T, Schmidlin PR,
Thurnheer T. Antibacterial efficacy of a propolis toothpaste and
mouthrinse against a supragingival multispecies biofilm. Oral Health
Prev Dent 2015;13:531-5.
6. Llena C, Ledya A, Forner L. CPP-ACP and CPP-ACFP versus fluoride
varnish in remineralisation of early caries lesions. A prospective study.
Eur J Pediatr Dent 2015;16:181-6.
7. Duailibe S, Gonçalves A, Ahid F. Effect of a propolis extract on
Streptococcus mutans counts in vivo. J Appl Oral Sci 2007;15:420-3.
8. Hegde KS, Bhat SS, Rao A, Sain S. Effect of propolis on Streptococcus
mutans counts: An in vivo study. Int J Clin Pediatr Dent 2013;6:22-5.
9. Hwu YJ, Lin FY. Effectiveness of propolis on oral health: A metaanalysis.
J Nurs Res 2014;22:221-9.
10. Listyasari N, Santoso O. Inhibition of dental plaque formation by
toothpaste containing propolis. Dent J 2012;45:208-11.
11. Plonka K, Pukallus M, Holcombe T, Barnett A, Walsh L, Seow W.
Randomized controlled trial: A randomized controlled clinical trial
comparing a remineralizing paste with an antibacterial gel to prevent
early childhood caries. Pediatr Dent 2013;35:8-12.
12. Emamieh S, Khaterizadeh Y, Goudarzi H, Ghasemi A, Baghban A,
Torabzadeh H. The effect of two types chewing gum containing casein
phosphopeptide-amorphous calcium phosphate and xylitol on salivary
Streptococcus mutans. J Conserv Dent 2015;18:192.
13. Rose RK. Binding characteristics of Streptococcus mutans for calcium
and casein phosphopeptide. Caries Res 2000;34:427-31.
14. Schüpbach P, Neeser JR, Golliard M, Rouvet M, Guggenheim B.
Incorporation of caseinoglycomacropeptide and caseinophosphopeptide
into the salivary pellicle inhibits adherence of mutans streptococci. J
Dent Res 1996;75:1779-88.
15. Sahlan M, Purwanti L. Tooth spray with active ingredients casein
phosphopeptide-amorphous calcium phosphate (CPP-ACP) and
ethanolic extract propolis (EEP) to inhibit tooth demineralization.
Commun Sci Technol 2016;1:56-60.
16. Soekanto SA, Duhita GC, Bachtiar EW, Sahlan M. The effect of CPPACP-
propolis chewing gum on calcium and phosphate ion release on
caries-active subjects’ saliva and the formation of Streptococcus mutans
biofilm. J Phys Conf Ser 2017;884:012137.