title: Acid resistance of enamel subsurface lesions remineralized by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate.
abstract: The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent). The study utilized a double-blind, randomized, crossover design with two treatments: (i) sugar-free gum containing 18.8 mg of CPP-ACP, and (ii) sugar-free gum not containing CPP-ACP as control. Subjects wore removable palatal appliances with insets of human enamel containing demineralized subsurface lesions and chewed the gum for 20 min 4 times per day for 14 days. After each treatment the enamel slabs were removed and half of each lesion challenged with acid in vitro for 8 or 16 h. The level of remineralization was determined using microradiography. The gum containing CPP-ACP produced approximately twice the level of remineralization as the control sugar-free gum. The 8- and 16-hour acid challenge of the lesions remineralized with the control gum resulted in 65.4 and 88.0% reductions, respectively, of deposited mineral, while for the CPP-ACP-remineralized lesions the corresponding reductions were 30.5 and 41.8%. The acid challenge after in situ remineralization for both control and CPP-ACP-treated lesions resulted in demineralization underneath the remineralized zone, indicating that the remineralized mineral was more resistant to subsequent acid challenge. The results show that sugar-free gum containing CPP-ACP is superior to an equivalent gum not containing CPP-ACP in remineralization of enamel subsurface lesions in situ with mineral that is more resistant to subsequent acid challenge.
authors.affiliation: Department of Preventive Dentistry, School of Dentistry, Nagasaki University, Nagasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Iijima
authors.forename: F
authors.initials: F
authors.lastname: Cai
authors.forename: P
authors.initials: P
authors.lastname: Shen
authors.forename: G
authors.initials: G
authors.lastname: Walker
authors.forename: C
authors.initials: C
authors.lastname: Reynolds
authors.forename: E C
authors.initials: EC
authors.lastname: Reynolds
mesh_terms: D019342:Acetic Acid / Q000494:pharmacology; D000328:Adult; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002364:Caseins / Q000627:therapeutic use*; D002638:Chewing Gum; D018592:Cross-Over Studies; D003743:Dental Enamel / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017001:Tooth Demineralization / Q000628:therapy*; D014089:Tooth Remineralization / Q000379:methods*; D014993:Xylitol
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; D002638:Chewing Gum; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D019342:Acetic Acid; D014993:Xylitol