Clinical effectiveness of the vitamin–mineral dietary supplement Cigapan for caries prevention in children

Relevance. Investigation of the effects of systemic interventions on the mineralization of dental hard tissues represents a promising direction in preventive pediatric dentistry. In contrast to topical remineralizing agents, whose effectiveness has been demonstrated in numerous clinical studies, the role of systemic preventive approaches, including dietary supplementation, in reducing dental caries in children remains insufficiently studied and requires further clinical validation.

Objective. To evaluate the clinical and diagnostic effectiveness of the dietary supplement Cigapan in improving the condition of dental hard tissues and periodontal tissues in children.

Materials and methods. The study included 60 children aged 8–17 years (mean age, 12 years). Participants were stratified into two groups according to caries experience: Group 1 (n = 30), children with low to moderate caries experience (DMFT < 4.5), and Group 2 (n = 30), children with high to very high caries experience (DMFT > 4.5). Dental status assessment involved evaluation of permanent teeth using the Simplified Oral Hygiene Index (OHI-S), the DMFT index, the enamel acid resistance test (TER test), and the International Caries Detection and Assessment System (ICDAS II). The degree of demineralization of initial enamel lesions in permanent teeth was measured by laser fluorescence using the DIAGNOdent Pen 2190 (Germany). Periodontal tissue status was assessed using the Papillary–Marginal–Attached (PMA) index and the Sulcus Bleeding Index (SBI). To evaluate the comparative effectiveness of the preventive intervention incorporating Cigapan, changes in dental and periodontal tissue parameters were monitored in both groups over a three-month follow-up period.

Results. The results demonstrated a statistically significant reduction in the extent of focal enamel demineralization and in the severity of demineralization of initial enamel lesions in both study groups (p < 0.05). In children with DMFT < 4.5 (Group 1), complete resolution of initial enamel lesions classified as ICDAS II code 1 was observed. The prevalence of ICDAS II code 2 lesions decreased by 78.6%. Laser fluorescence measurements indicated a 67.6% increase in mineralization within affected enamel sites (p < 0.05), confirming the effectiveness of the intervention. In children with high caries activity (Group 2), a statistically significant reduction in ICDAS II code 1 lesions was also recorded, with a decrease of 76.9% (p < 0.05). According to DIAGNOdent Pen 2190 measurements, mineralization levels in demineralized enamel areas increased by 72.4% compared with baseline values (p < 0.05). A reduction in ICDAS II code 2 lesions was likewise observed (26%), accompanied by a 53.9% increase in enamel mineralization as assessed by laser fluorescence; all observed differences were statistically significant (p < 0.05).

Conclusion. Incorporation of the dietary supplement Cigapan as part of systemic preventive therapy within a comprehensive prevention program led to improvements in oral hygiene and gingival health in children, reduced enamel permeability, increased acid resistance of permanent teeth, a decreased prevalence of early carious lesions, and enhanced mineralization in areas of enamel demineralization.

1. Meyer F, Schulze ZurWiesche E, Amaechi BT, Limeback H, Enax J. Caries Etiology and Preventive Measures. Eur J Dent. 2024;18(3):766-776. https://doi.org/10.1055/s-0043-1777051

2. Ekimov E.V., Skripkina G.I., Garifullina A.J. Estimation of efficiency of treatment of initial tooth decay forchildren at the different degree of activity of pathologicalprocess. The Dental Institute. 2018;(4):74-75 (In Russ.). Available from: https://elibrary.ru/item.asp?id=36762493

3. Ben Taheur F, Kouidhi B, Fdhila K, Elabed H, Ben Slama R, Mahdouani K, et al.Anti-bacterial and antibiofilm activity of probiotic bacteria against oralpathogens. MicrobPathog. 2 016;97:213-20. https://doi.org/10.1016/j.micpath.2016.06.018

4. Jullien S. Prophylaxis of caries with fluoride forchildren under five years. BMC Pediatr. 2021;21(Suppl 1):351. doi: 10.1186/s12887-021-02702-3

5. Chernyavskaya N.D., Terekhova T.N. Detection of initial occlusal caries in the first permanent molars by laser fluorescence and the ICDAS. Sovremennaya stomatologiya. 2021;(2):26-30 (In Russ.). Available from: https://elibrary.ru/item.asp?id=46500747

6. O'Mullane DM, Baez RJ, Jones S, Lennon MA, Petersen PE, Rugg-Gunn AJet al. Fluoride and Oral Health. Community Dent Health. 2016;33(2):69-99. Available from: https://pubmed.ncbi.nlm.nih.gov/27352462/

7. Yekimov E.V., Skripkina G.I., Smetanin A.A., Korshunov A.P. Objective evaluation of the caries prevention efficiency. Stomatology. 2021;100(5):15-18 (In Russ.). https://doi.org/10.17116/stomat202110005115

8. Zharkova O.A. The usage of GC Tooth Mousse in remineralization therapy. Problemy stomatologii. 2012;(1):33 (In Russ.). Available from: https://elibrary.ru/item.asp?id=17651434

9. Alekseeva I.A., Kiselnikova L.P., Ostrovskaya Yu.A., Danilova I.G. Assessment of some incipient caries risk factors in adolescents. Pediatric dentistry and dental prophylaxis. 2022;22(4):291-298 (In Russ.). https://doi.org/10.33925/1683 3031-2022-22-4-291-298

10. Kiselnikova L.P., Alekseyeva I.A., Danilova I.G., Gette I.F., Ojgikhina N.V. The analysis of characteristics of phosphoric calcium metabolism in pathogenesis of caries in children of adolescent age. Russian Medicine. 2014;20(2):27-30 (In Russ.). https://doi.org/10.17816/rmj38173

11. KimIJ, Lee HS, Ju HJ, Na JY, OhHW. A cross-sectional study on the association between vitamin D levels and caries in the permanent dentition of Korean children. BMC Oral Health. 2018;18(1):43. doi: 10.1186/s12903-018-0505-7

12. Gil Á, Plaza-Diaz J, Mesa MD. Vitamin D: Classicand Novel Actions. AnnNutrMetab. 2018;72(2):87-95. doi: 10.1159/000486536

13. Plotnikova Ch.Yu., Gasparyan L.A., Gerasimova T.V., Katvtayeva T.G. Endogenous prevention of dental caries. Sovremennye tendencii razvitiya nauki i tehnologij. 2016;(5-1):138-140 (In Russ.). Available from: https://www.elibrary.ru/item.asp?edn=waefml&ysclid=mi30oe4c2f814366494

14. Kisellnikova L. P., Alekseeva I. A., Shcheplyagina L. A. Correction capabilities to adolescents with calcium and the effect of this factor on the change of resistance of the teeth to decay. Pediatric dentistry and dental prophylaxis. 2013;12(1):30-34 (In Russ.). Available from: https://elibrary.ru/item.asp?id=19034138

15. Machulina N.A., Kamenskikh D.V. Some aspects of the endogenous prevention of dental caries in preschool children. Modern problems of science and education. 2016;(3):182. Available from: https://science-education.ru/article/view?id=24844&ysclid=mi30qq7icn931035838

16. Timofeeva A.A., Timofeeva V.N. The effectiveness of synbiotics in improving the dental health of adolescents. Russian Journal of Stomatology. 2016;9(1):50-49 (In Russ.). Available from: https://www.mediasphera.ru/issues/rossijskaya-stomatologiya/2016/1/082072-640620150132

17. Maltsev S.V., Arkhipova N.N. Genetically determined disorders of phosphate metabolism in children and ways to correct them. Kazan medical journal. 2004;85(5):374-376. Available from: https://elibrary.ru/item.asp?id=9115629

18. Novikov P.V. Administration of biologically active additive Cigapan in comprehensive therapy of vitamin D-resistant rickets in children. Pediatric pharmacology. 2003;1(2):52-54. Available from: https://elibrary.ru/item.asp?id=18838441

19. Jaafar N, Ragab H, Abedrahman A, Osman E. An In Vivo Investigation of Diagnostic Performance of DIAGNOdent Pen and the Canary System for Assessment and Monitoring Enamel Caries under Fissure Sealants. J IntSocPrev Community Dent. 2020;10(3):246-254. https://doi.org/10.4103/jispcd.jispcd_480_19