Remineralization of enamel subsurface lesions by chewing gum with added calcium.
OBJECTIVE
Chewing sugar-free gum has been shown to promote enamel remineralization. Manufacturers are now adding calcium to the gum in an approach to further promote enamel remineralization. The aim of this study was to compare the remineralization efficacy of four sugar-free chewing gums, two containing added calcium, utilizing a double-blind, randomized, crossover in situ model.


METHODS
The sugar-free gums were: Trident Xtra Care, Orbit Professional, Orbit and Extra. Ten subjects wore removable palatal appliances with four human-enamel half-slab insets containing subsurface demineralized lesions. For four times a day for 14 consecutive days subjects chewed one of the chewing gums for 20min. After each treatment the enamel slabs were removed, paired with their respective demineralized control slabs, embedded, sectioned and mineral level determined by microradiography. After 1-week rest the subjects chewed another of the four gums and this was repeated until each subject had used the four gum products.


RESULTS
Chewing with Trident Xtra Care resulted in significantly higher remineralization (20.67+/-1.05%) than chewing with Orbit Professional (12.43+/-0.64%), Orbit (9.27+/-0.59%) or Extra (9.32+/-0.35%). The form of added calcium in Trident Xtra Care was CPP-ACP and that in Orbit Professional calcium carbonate with added citric acid/citrate for increased calcium solubility.


CONCLUSIONS
Although saliva analysis confirmed release of the citrate and calcium from the Orbit Professional gum the released calcium did not result in increased enamel remineralization over the normal sugar-free gums. These results highlight the importance of calcium ion bioavailability in the remineralization of enamel subsurface lesions in situ.
Cai
Fan
F
Cooperative Research Centre for Oral Health Science, Melbourne Dental School and The Bio21 Institute of Molecular Science and Biotechnology, The University of Melbourne, 720 Swanson Street, Victoria, 3010, Australia.
Shen
Peiyan
P
Walker
Glenn D
GD
Reynolds
Coralie
C
Yuan
Yi
Y
Reynolds
Eric C
EC
D000328:Adult; D001682:Biological Availability; D002118:Calcium / Q000493:pharmacokinetics*; D002119:Calcium Carbonate / Q000493:pharmacokinetics; D002327:Cariostatic Agents / Q000493:pharmacokinetics*; D002364:Caseins / Q000493:pharmacokinetics; D002638:Chewing Gum; D018592:Cross-Over Studies; D003731:Dental Caries / Q000628:therapy*; D003743:Dental Enamel / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000378:metabolism; D012636:Secretory Rate; D013402:Sugar Alcohols; D013549:Sweetening Agents; D014089:Tooth Remineralization / Q000379:methods*
D002327:Cariostatic Agents; D002364:Caseins; D002638:Chewing Gum; D013402:Sugar Alcohols; D013549:Sweetening Agents; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D002119:Calcium Carbonate; D002118:Calcium