title: Effects of a chewing gum containing phosphoryl oligosaccharides of calcium (POs-Ca) and fluoride on remineralization and crystallization of enamel subsurface lesions in situ.
abstract: OBJECTIVE
  Manufacturers are adding fluoride (F) to calcium-containing chewing gums to further promote enamel remineralization. The aim of this study was to assess the effect of a chewing gum containing phosphoryl oligosaccharides of calcium (POs-Ca) and fluoride on remineralization of enamel subsurface lesions, in a double-blind, randomized controlled in situ trial.
  
  
  METHODS
  Thirty-six volunteer subjects wore removable buccal appliances with three different insets of bovine enamel with subsurface demineralized lesions. For 14 days the subjects chewed one of the three chewing gums (placebo, POs-Ca, POs-Ca+F), three times a day. After each treatment period, the insets were removed from the appliance, embedded, sectioned, polished and then subjected to laboratory tests; mineral level was determined by transverse microradiography (TMR; n=36), and hydroxyapatite (HAp) crystallites were assessed by synchrotron radiation wide-angle X-ray diffraction (WAXRD; n=13). Data were analysed by t-test or Wilcoxon rank-sum test with Bonferroni corrections at 0.05 significance level.
  
  
  RESULTS
  Chewing POs-Ca and POs-Ca+F gums resulted in 21.9±10.6 and 26.3±9.4 (mean±SD) percentage mineral recovery, which was significantly higher than that of placebo gum (15.0±11.4) (p<0.05). Chewing POs-Ca+F gum resulted in 24.9±5.4 (mean±SD) percentage HAp crystallites recovery, which was significantly higher compared to POs-Ca (16.0±4.1%) or placebo (11.1±4.8%) gums (p<0.05).
  
  
  CONCLUSIONS
  Addition of POs-Ca to the chewing gum resulted in significant remineralization of enamel subsurface lesions. Although POs-Ca+F gum was not superior in TMR recovery rate when compared with POs-Ca gum, WAXRD results highlighted the importance of fluoride ion bioavailability in the formation of HAp crystallites in enamel subsurface lesions in situ (NCT01377493).
authors.affiliation: Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. kitasako.ope@tmd.ac.jp
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kitasako
authors.forename: Miyuki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Alireza
authors.initials: A
authors.lastname: Sadr
authors.forename: Hidenori
authors.initials: H
authors.lastname: Hamba
authors.forename: Masaomi
authors.initials: M
authors.lastname: Ikeda
authors.forename: Junji
authors.initials: J
authors.lastname: Tagami
mesh_terms: D000328:Adult; D000818:Animals; D001682:Biological Availability; D017610:Calcium Compounds / Q000493:pharmacokinetics; D002417:Cattle; D002638:Chewing Gum; D003460:Crystallization; D018360:Crystallography, X-Ray / Q000379:methods; D003731:Dental Caries / Q000378:metabolism* / Q000473:pathology; D003743:Dental Enamel / Q000378:metabolism* / Q000473:pathology; D004311:Double-Blind Method; D017886:Durapatite / Q000032:analysis; D005260:Female; D005459:Fluorides / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008852:Microradiography; D009844:Oligosaccharides / Q000493:pharmacokinetics; D010755:Organophosphates / Q000493:pharmacokinetics; D010710:Phosphates / Q000493:pharmacokinetics; D018709:Statistics, Nonparametric; D014089:Tooth Remineralization / Q000379:methods*; D055815:Young Adult
chemical_list: D017610:Calcium Compounds; D002638:Chewing Gum; D009844:Oligosaccharides; D010755:Organophosphates; D010710:Phosphates; C012980:fluorophosphate; D017886:Durapatite; D005459:Fluorides