Effect of addition of citric acid and casein phosphopeptide-amorphous calcium phosphate to a sugar-free chewing gum on enamel remineralization in situ.
Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been shown to remineralize enamel subsurface lesions in situ. The aim of this study was to investigate the effects of CPP-ACP in a fruit-flavoured sugar-free chewing gum containing citric acid on enamel remineralization, and acid resistance of the remineralized enamel, using an in situ remineralization model. The study utilized a double-blind, randomized, crossover design with three treatments: (i) sugar-free gum (2 pellets) containing 20 mg citric acid and 18.8 mg CPP-ACP, (ii) sugar-free gum containing 20 mg citric acid alone, (iii) sugar-free gum not containing CPP-ACP or citric acid. Ten subjects were instructed to wear removable palatal appliances, with 4 half-slab insets of human enamel containing demineralized subsurface lesions and to chew gum (2 pellets) for 20 min 4 times per day for 14 days. At the completion of each treatment the enamel half-slabs were removed and half of the remineralized lesion treated with demineralization buffer for 16 h in vitro. The enamel slabs (remineralized, acid-challenged and control) were then embedded, sectioned and subjected to microradiography to determine the level of remineralization. Chewing with gum containing citric acid and CPP-ACP resulted in significantly higher remineralization (13.0 +/- 2.2%) than chewing with either gum containing no CPP-ACP or citric acid (9.4 +/- 1.2%) or gum containing citric acid alone (2.6 +/- 1.3%). The acid challenge of the remineralized lesions showed that the level of mineral after acid challenge was significantly greater for the lesions exposed to the gum containing CPP-ACP.
Cai
F
F
Cooperative Research Centre for Oral Health Science, School of Dental Science and the Bio21 Institute of Molecular Science and Biotechnology, The University of Melbourne, Parkville, Vic., Australia.
Manton
D J
DJ
Shen
P
P
Walker
G D
GD
Cross
K J
KJ
Yuan
Y
Y
Reynolds
C
C
Reynolds
E C
EC
D000328:Adult; D002327:Cariostatic Agents / Q000494:pharmacology*; D002364:Caseins / Q000494:pharmacology*; D002638:Chewing Gum; D019343:Citric Acid / Q000494:pharmacology*; D003743:Dental Enamel / Q000187:drug effects; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D014089:Tooth Remineralization / Q000379:methods*
D002327:Cariostatic Agents; D002364:Caseins; D002638:Chewing Gum; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D019343:Citric Acid