According to a recent study in ‘Acta Odontologica Scandinavica’, the use of CPP-ACP- topical fluoride (TF) was associated with improved remineralization of prevailing lesions and exhibited improved antibacterial effect but not carries occurrence as compared to TF alone. Nevertheless, Xylitol depicts an additional advantage over fluoride alone in stopping the development of caries.

Authors compared the remineralization potential and caries preventive efficacy of combination therapy of CPP-ACP/bioactive glass/xylitol/ozone and TF against TF therapy alone.

On the whole, 4457 records were screened and 26 trials were counted in after database search (PubMed, Scopus, PubMed, Web of Science and Cochrane). The data from 16 trials was pooled with a significance level being p < .05. GRADE was used to assess the evidence certainty.

A superiority of ‘xylitol-TF’ and ‘CPP-ACP-TF’ combined therapy was observed based on the pooled analysis of 2 trials concerning white spot lesions regression and 3 trials for post-intervention DIAGNOdent values (to identify and find cavities). As concluded from this review, the high or unclear risk of bias, imprecision and obliqueness of the comprised trials represented a poor evidence certainty.