title: Effects of Isomalt on enamel de- and remineralization, a combined in vitro pH-cycling model and in situ study.
abstract: Isomalt is a non-cariogenic sweetener, which is widely used in sugar-free candy and chewing gum. Little is known about the effects of Isomalt on de- and remineralization. Binding between calcium and Isomalt has been reported, which could affect the mineral balance. The objective of this study was to examine the effects of Isomalt on de- and remineralization of bovine enamel lesions, both in vitro and in situ. In in vitro study, subsurface enamel lesions were subjected to 3-weeks pH-cycling. Treatments were 5-min rinses with 10% Isomalt solutions daily and 10% Isomalt additions to re- or demineralizing solutions. Standard pH-cycling conditions were used with a 0.2 ppm fluoride background during the remineralization phase. In in situ study, subsurface lesions were exposed 2 months in vivo and brushed three times daily with 10% Isomalt containing toothpaste. Treatment effects were assessed by chemical analysis of the solutions (in vitro) and transversal microradiography (in vitro and in situ). In in vitro study, while 5-min rinses with 10% Isomalt gave slightly increased remineralization, continuous presence of 10% Isomalt (in re- or demineralizing solutions) inhibited both de- and/or remineralization. This lead to significantly smaller overall mineral loss when Isomalt was added during demineralization. In in situ study, remineralization enhancement during short Isomalt treatments was confirmed. Isomalt had a positive effect on the de/remineralization balance when given under conditions relevant to practical use.
authors.affiliation: Health Care R&D Division, Sunstar Inc, Asahimachi, Takatsuki, Osaka, Japan. tsutomu.takatsuka@sunstar.com
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takatsuka
authors.forename: Rob A M
authors.initials: RA
authors.lastname: Exterkate
authors.forename: Jacob M
authors.initials: JM
authors.lastname: ten Cate
mesh_terms: D000328:Adult; D000818:Animals; D002118:Calcium / Q000032:analysis / Q000493:pharmacokinetics; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002417:Cattle; D018592:Cross-Over Studies; D003743:Dental Enamel / Q000187:drug effects* / Q000378:metabolism; D004187:Disaccharides / Q000627:therapeutic use*; D005459:Fluorides / Q000627:therapeutic use; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008422:Materials Testing; D008852:Microradiography; D009067:Mouthwashes / Q000627:therapeutic use; D013402:Sugar Alcohols / Q000627:therapeutic use*; D013549:Sweetening Agents / Q000627:therapeutic use*; D017001:Tooth Demineralization / Q000209:etiology*; D014089:Tooth Remineralization / Q000379:methods; D014099:Toothbrushing; D014100:Toothpastes / Q000627:therapeutic use
chemical_list: D002327:Cariostatic Agents; D004187:Disaccharides; D009067:Mouthwashes; D013402:Sugar Alcohols; D013549:Sweetening Agents; D014100:Toothpastes; C016640:Palatinit; D005459:Fluorides; D002118:Calcium