title: White spot lesion remineralization by sugar-free chewing gum containing bio-available calcium and fluoride: A double-blind randomized controlled trial.
abstract: To assess the effect of chewing gum containing phosphoryl oligosaccharides of calcium (POs-Ca) and fluoride on white spot lesion (WSL) remineralization in comparison with POs-Ca or placebo (control) chewing gums, in double- blind, randomized, controlled trial.
  
  
  
  Thirty-seven healthy subjects, who had at least one WSL, with an ICDAS score of 2 or 1, were recruited for this study. The subjects were randomly divided into three groups (control, POs-Ca, POs-Ca+F) and chewed two slabs of each gum three times every day for 3 months. WSLs were assessed using ICDAS criteria and optical boundary depth (BD) by optical coherence tomography (OCT) system at a monthly recall. Data were analyzed by Wilcoxon rank-sum test and Wilcoxon signed rank test with Bonferroni corrections at 0.05 significance level.
  
  
  
  Visual score changes from ICDAS score 2 to score 1 over the course of the study were observed; control (30%), POs-Ca (48%) and POs-Ca+F (45%). Unlike the control gum, chewing POs-Ca and POs-Ca+F gums resulted in significant changes in the mean value of BD over the 3 months course of the study (p<0.05). There was a significant difference in mean value of BD after first month between POs-Ca+F and control groups (p<0.05).
  
  
  
  This study highlighted the importance of calcium and fluoride ion bioavailability in the reinforcement of demineralized enamel lesions by chewing gums. Furthermore, adding fluoride to POs-Ca might speed up the remineralization progress on natural WSL.
authors.affiliation: Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Sugiura
authors.affiliation: Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Dental Clinic, Ministry of Foreign Affairs, Tokyo, Japan. Electronic address: kitasako.ope@tmd.ac.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kitasako
authors.affiliation: Biomimetics Biomaterials Biophotonics & Technology Laboratory, Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA.
authors.forename: Alireza
authors.initials: A
authors.lastname: Sadr
authors.affiliation: Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shimada
authors.affiliation: Department for Advanced Dental Research, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Aichi, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sumi
authors.affiliation: Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Tagami
mesh_terms: D002118:Calcium; D002638:Chewing Gum; D003731:Dental Caries; D004311:Double-Blind Method; D005459:Fluorides; D006801:Humans; D000073893:Sugars; D014089:Tooth Remineralization
chemical_list: D002638:Chewing Gum; D000073893:Sugars; D005459:Fluorides; D002118:Calcium
keywords: Chewing gum; Double-blind; Enamel; Randomized controlled trial; Remineralization; White spot