title: Remineralisation by chewing sugar-free gums in a randomised, controlled in situ trial including dietary intake and gauze to promote plaque formation.
abstract: Remineralisation has been shown to be an effective mechanism of preventing the progression of enamel caries. The aim of this double-blind, randomised, cross-over in situ study was to compare enamel remineralisation by chewing sugar-free gum with or without casein phosphopeptide amorphous calcium phosphate (CPP-ACP) where the enamel lesions were exposed to dietary intake and some were covered with gauze to promote plaque formation. Participants wore removable palatal appliances containing 3 recessed enamel half-slabs with subsurface lesions covered with gauze and 3 without gauze. Mineral content was measured by transverse microradiography, and plaque composition was analysed by real-time polymerase chain reaction. For both the gauze-free and gauze-covered lesions, the greatest amount of remineralisation was produced by the CPP-ACP sugar-free gum, followed by the gum without CPP-ACP and then the no-gum control. Recessing the enamel in the appliance allowed plaque accumulation without the need for gauze. There was a trend of less remineralisation and greater variation in mineral content for the gauze-covered lesions. The cell numbers of total bacteria and streptococci were slightly higher in the plaque from the gauze-covered enamel for 2 of the 3 treatment legs; however, there was no significant difference in Streptococcus mutans cell numbers. In conclusion, chewing sugar-free gum containing CPP-ACP promoted greater levels of remineralisation than a sugar-free gum without CPP-ACP or a no-gum control using an in situ remineralisation model including dietary intake irrespective of whether gauze was used to promote plaque formation or not.
authors.affiliation: Oral Health CRC, Melbourne Dental School, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: N J
authors.initials: NJ
authors.lastname: Cochrane
authors.forename: P
authors.initials: P
authors.lastname: Shen
authors.forename: S J
authors.initials: SJ
authors.lastname: Byrne
authors.forename: G D
authors.initials: GD
authors.lastname: Walker
authors.forename: G G
authors.initials: GG
authors.lastname: Adams
authors.forename: Y
authors.initials: Y
authors.lastname: Yuan
authors.forename: C
authors.initials: C
authors.lastname: Reynolds
authors.forename: B
authors.initials: B
authors.lastname: Hoffmann
authors.forename: S G
authors.initials: SG
authors.lastname: Dashper
authors.forename: E C
authors.initials: EC
authors.lastname: Reynolds
mesh_terms: D000328:Adult; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002364:Caseins / Q000627:therapeutic use*; D002638:Chewing Gum; D018592:Cross-Over Studies; D004269:DNA, Bacterial / Q000032:analysis; D003731:Dental Caries / Q000517:prevention & control*; D003743:Dental Enamel / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D003773:Dental Plaque / Q000382:microbiology / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D005502:Food; D006801:Humans; D016014:Linear Models; D008297:Male; D008852:Microradiography; D008875:Middle Aged; D013295:Streptococcus mutans / Q000235:genetics; D013549:Sweetening Agents; D014089:Tooth Remineralization / Q000379:methods*; D055815:Young Adult
chemical_list: D002327:Cariostatic Agents; D002364:Caseins; D002638:Chewing Gum; D004269:DNA, Bacterial; D013549:Sweetening Agents; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex