Comparison of efficiency of casein phosphopeptide-amorphous calcium phosphate and resin infiltration applications used in the treatment of postorthodontic white spot lesions

Aim: This study aimed to compare the effectiveness of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and resin infiltration methods in the treatment of white spot lesions (WSLs) following fixed orthodontic treatment. Materials and Methods: The study included 104 maxillary anterior teeth from 18 patients who had completed fixed orthodontic treatment in our clinic between 2018 and 2023 years. Treatment of symmetric localized WSLs was initiated one month after debonding. In this randomized split-mouth trial, CPP-ACP and resin infiltration were applied to the right and left maxillary anterior teeth, respectively, and their effectiveness in treating of WSLs was compared. Demineralization values were measured using a DIAGNOdent pen device at one month post-debonding (T0), and at 1st (T1), 3rd (T2), and 6th (T3) months of treatment. Data were statistically analyzed. Independent samples t-test was used to compare mean demineralization values between applications, and one-way ANOVA was used to compare different tooth types. Kruskal-Wallis test was applied to evaluate demineralization changes at different time intervals, and Mann-Whitney U test was used to compare total demineralization changes between the applications. Statistical significance was set at p<0.05. Results: Both applications showed a significant reduction in demineralization values from baseline to the sixth month (p<0.05). Except for the mean demineralization values recorded from central incisors at T2 in the resin infiltration group, no statistically significant differences were found among tooth types in either application. Resin infiltration demonstrated higher effectiveness at T0–T1, while CPP-ACP showed greater effectiveness at T1–T2 time interval (p<0.05). However, after 6 months of treatment, no significant difference was observed between methods in terms of WSL treatment efficacy. Conclusion: Although resin infiltration was more effective at the 1st month and CPP-ACP up to the 3rd month, both methods demonstrated similar outcomes after 6 months. WSLs were successfully treated with both applications.