title: The anticariogenic effect of sugar-free gum containing CPP-ACP nanocomplexes on approximal caries determined using digital bitewing radiography.
abstract: This study investigated, using digital bitewing radiography, the progression and regression of approximal caries in adolescent subjects chewing a sugar-free gum containing 54 mg CPP-ACP relative to the identical gum without CPP-ACP. 2,720 subjects from 29 schools were randomly assigned to one of the two gums and were instructed to chew their assigned gum for 3 x 10 min/day, with one session supervised on school days, over the 24-month study period. Standardized digital bitewing radiographs were taken at the baseline and 24-month clinical examinations for each subject. The radiographs, scored by a single examiner, were assessed for approximal surface dental caries at both the enamel and dentine level. Surface level transitions were scored using a transition matrix. Caries progression or regression was analysed using proportional-odds ordered logistic regression modelling of the transition scores at the tooth surface level. There was a statistically significant difference in the frequency distributions of the transition scores between the two gum groups (OR = 0.82, p = 0.03). For subjects chewing the CPP-ACP gum the odds of a surface experiencing caries progression were 18% less than those of a surface experiencing caries progression for subjects chewing the control gum. In conclusion, the 54 mg CPP-ACP sugar-free gum significantly slowed progression and enhanced regression of approximal caries relative to a control sugar-free gum in a 24-month clinical trial.
authors.affiliation: Cooperative Research Centre for Oral Health Science, School of Dental Science, Bio21 Institute, University of Melbourne, Parkville, Vic., Australia.
authors.forename: M V
authors.initials: MV
authors.lastname: Morgan
authors.forename: G G
authors.initials: GG
authors.lastname: Adams
authors.forename: D L
authors.initials: DL
authors.lastname: Bailey
authors.forename: C E
authors.initials: CE
authors.lastname: Tsao
authors.forename: S L
authors.initials: SL
authors.lastname: Fischman
authors.forename: E C
authors.initials: EC
authors.lastname: Reynolds
mesh_terms: D000293:Adolescent; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002364:Caseins / Q000627:therapeutic use*; D002638:Chewing Gum / Q000032:analysis; D002648:Child; D003731:Dental Caries / Q000000981:diagnostic imaging / Q000517:prevention & control*; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D016300:Radiography, Bitewing; D019252:Radiography, Dental, Digital; D018401:Sample Size; D013012:Sorbitol; D013549:Sweetening Agents; D014089:Tooth Remineralization / Q000379:methods
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; D002638:Chewing Gum; D013549:Sweetening Agents; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D013012:Sorbitol