Acid Resistance of Enamel Subsurface Lesions Remineralized by a Sugar-Free Chewing Gum Containing Casein Phosphopeptide-Amorphous Calcium Phosphate

The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent™). The study utilized a double-blind, randomized, crossover design...

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Vydané v:Caries research Ročník 38; číslo 6; s. 551 - 556
Hlavní autori: Iijima, Y., Cai, F., Shen, P., Walker, G., Reynolds, C., Reynolds, E.C.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Basel, Switzerland S. Karger AG 01.01.2004
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ISSN:0008-6568, 1421-976X
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Abstract The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent™). The study utilized a double-blind, randomized, crossover design with two treatments: (i) sugar-free gum containing 18.8 mg of CPP-ACP, and (ii) sugar-free gum not containing CPP-ACP as control. Subjects wore removable palatal appliances with insets of human enamel containing demineralized subsurface lesions and chewed the gum for 20 min 4 times per day for 14 days. After each treatment the enamel slabs were removed and half of each lesion challenged with acid in vitro for 8 or 16 h. The level of remineralization was determined using microradiography. The gum containing CPP-ACP produced approximately twice the level of remineralization as the control sugar-free gum. The 8- and 16-hour acid challenge of the lesions remineralized with the control gum resulted in 65.4 and 88.0% reductions, respectively, of deposited mineral, while for the CPP-ACP-remineralized lesions the corresponding reductions were 30.5 and 41.8%. The acid challenge after in situ remineralization for both control and CPP-ACP-treated lesions resulted in demineralization underneath the remineralized zone, indicating that the remineralized mineral was more resistant to subsequent acid challenge. The results show that sugar-free gum containing CPP-ACP is superior to an equivalent gum not containing CPP-ACP in remineralization of enamel subsurface lesions in situ with mineral that is more resistant to subsequent acid challenge.
AbstractList The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent™). The study utilized a double-blind, randomized, crossover design with two treatments: (i) sugar-free gum containing 18.8 mg of CPP-ACP, and (ii) sugar-free gum not containing CPP-ACP as control. Subjects wore removable palatal appliances with insets of human enamel containing demineralized subsurface lesions and chewed the gum for 20 min 4 times per day for 14 days. After each treatment the enamel slabs were removed and half of each lesion challenged with acid in vitro for 8 or 16 h. The level of remineralization was determined using microradiography. The gum containing CPP-ACP produced approximately twice the level of remineralization as the control sugar-free gum. The 8- and 16-hour acid challenge of the lesions remineralized with the control gum resulted in 65.4 and 88.0% reductions, respectively, of deposited mineral, while for the CPP-ACP-remineralized lesions the corresponding reductions were 30.5 and 41.8%. The acid challenge after in situ remineralization for both control and CPP-ACP-treated lesions resulted in demineralization underneath the remineralized zone, indicating that the remineralized mineral was more resistant to subsequent acid challenge. The results show that sugar-free gum containing CPP-ACP is superior to an equivalent gum not containing CPP-ACP in remineralization of enamel subsurface lesions in situ with mineral that is more resistant to subsequent acid challenge.
The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent). The study utilized a double-blind, randomized, crossover design with two treatments: (i) sugar-free gum containing 18.8 mg of CPP-ACP, and (ii) sugar-free gum not containing CPP-ACP as control. Subjects wore removable palatal appliances with insets of human enamel containing demineralized subsurface lesions and chewed the gum for 20 min 4 times per day for 14 days. After each treatment the enamel slabs were removed and half of each lesion challenged with acid in vitro for 8 or 16 h. The level of remineralization was determined using microradiography. The gum containing CPP-ACP produced approximately twice the level of remineralization as the control sugar-free gum. The 8- and 16-hour acid challenge of the lesions remineralized with the control gum resulted in 65.4 and 88.0% reductions, respectively, of deposited mineral, while for the CPP-ACP-remineralized lesions the corresponding reductions were 30.5 and 41.8%. The acid challenge after in situ remineralization for both control and CPP-ACP-treated lesions resulted in demineralization underneath the remineralized zone, indicating that the remineralized mineral was more resistant to subsequent acid challenge. The results show that sugar-free gum containing CPP-ACP is superior to an equivalent gum not containing CPP-ACP in remineralization of enamel subsurface lesions in situ with mineral that is more resistant to subsequent acid challenge.The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent). The study utilized a double-blind, randomized, crossover design with two treatments: (i) sugar-free gum containing 18.8 mg of CPP-ACP, and (ii) sugar-free gum not containing CPP-ACP as control. Subjects wore removable palatal appliances with insets of human enamel containing demineralized subsurface lesions and chewed the gum for 20 min 4 times per day for 14 days. After each treatment the enamel slabs were removed and half of each lesion challenged with acid in vitro for 8 or 16 h. The level of remineralization was determined using microradiography. The gum containing CPP-ACP produced approximately twice the level of remineralization as the control sugar-free gum. The 8- and 16-hour acid challenge of the lesions remineralized with the control gum resulted in 65.4 and 88.0% reductions, respectively, of deposited mineral, while for the CPP-ACP-remineralized lesions the corresponding reductions were 30.5 and 41.8%. The acid challenge after in situ remineralization for both control and CPP-ACP-treated lesions resulted in demineralization underneath the remineralized zone, indicating that the remineralized mineral was more resistant to subsequent acid challenge. The results show that sugar-free gum containing CPP-ACP is superior to an equivalent gum not containing CPP-ACP in remineralization of enamel subsurface lesions in situ with mineral that is more resistant to subsequent acid challenge.
The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent(TM)). The study utilized a double-blind, randomized, crossover design with two treatments: (i) sugar-free gum containing 18.8 mg of CPP-ACP, and (ii) sugar-free gum not containing CPP-ACP as control. Subjects wore removable palatal appliances with insets of human enamel containing demineralized subsurface lesions and chewed the gum for 20 min 4 times per day for 14 days. After each treatment the enamel slabs were removed and half of each lesion challenged with acid in vitro for 8 or 16 h. The level of remineralization was determined using microradiography. The gum containing CPP-ACP produced approximately twice the level of remineralization as the control sugar-free gum. The 8- and 16-hour acid challenge of the lesions remineralized with the control gum resulted in 65.4 and 88.0% reductions, respectively, of deposited mineral, while for the CPP-ACP-remineralized lesions the corresponding reductions were 30.5 and 41.8%. The acid challenge after in situ remineralization for both control and CPP-ACP-treated lesions resulted in demineralization underneath the remineralized zone, indicating that the remineralized mineral was more resistant to subsequent acid challenge. The results show that sugar-free gum containing CPP-ACP is superior to an equivalent gum not containing CPP-ACP in remineralization of enamel subsurface lesions in situ with mineral that is more resistant to subsequent acid challenge. Copyright © 2004 S. Karger AG, Basel
The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent). The study utilized a double-blind, randomized, crossover design with two treatments: (i) sugar-free gum containing 18.8 mg of CPP-ACP, and (ii) sugar-free gum not containing CPP-ACP as control. Subjects wore removable palatal appliances with insets of human enamel containing demineralized subsurface lesions and chewed the gum for 20 min 4 times per day for 14 days. After each treatment the enamel slabs were removed and half of each lesion challenged with acid in vitro for 8 or 16 h. The level of remineralization was determined using microradiography. The gum containing CPP-ACP produced approximately twice the level of remineralization as the control sugar-free gum. The 8- and 16-hour acid challenge of the lesions remineralized with the control gum resulted in 65.4 and 88.0% reductions, respectively, of deposited mineral, while for the CPP-ACP-remineralized lesions the corresponding reductions were 30.5 and 41.8%. The acid challenge after in situ remineralization for both control and CPP-ACP-treated lesions resulted in demineralization underneath the remineralized zone, indicating that the remineralized mineral was more resistant to subsequent acid challenge. The results show that sugar-free gum containing CPP-ACP is superior to an equivalent gum not containing CPP-ACP in remineralization of enamel subsurface lesions in situ with mineral that is more resistant to subsequent acid challenge.
Author Walker, G.
Reynolds, C.
Cai, F.
Iijima, Y.
Shen, P.
Reynolds, E.C.
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  surname: Shen
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  surname: Walker
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  givenname: C.
  surname: Reynolds
  fullname: Reynolds, C.
– sequence: 6
  givenname: E.C.
  surname: Reynolds
  fullname: Reynolds, E.C.
BackLink https://www.ncbi.nlm.nih.gov/pubmed/15528910$$D View this record in MEDLINE/PubMed
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Issue 6
Keywords Casein phosphopeptide-stabilized amorphous calcium phosphate
Acid resistance
Enamel subsurface lesion remineralization
Language English
License Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
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PublicationDecade 2000
PublicationPlace Basel, Switzerland
PublicationPlace_xml – name: Basel, Switzerland
– name: Switzerland
– name: Basel
PublicationTitle Caries research
PublicationTitleAlternate Caries Res
PublicationYear 2004
Publisher S. Karger AG
Publisher_xml – name: S. Karger AG
References Malcolm AS: A microradiographic apparatus. Aust Dent J 1972;17:454-460.451198210.1111%2Fj.1834-7819.1972.tb04977.x
LeGeros RZ, Sakae T, Bautista C, Retino M, LeGeros JP: Magnesium and carbonate in enamel and synthetic apatites. Adv Dent Res 1996;10:225-231.920634110.1177%2F08959374960100021801
White DJ: Use of synthetic-polymer gels for artificial carious lesion preparation. Caries Res 1987;21:228-242.347134610.1159%2F000261026
Angmar B, Carlström D, Glas JE: Studies on the ultrastructure of dental enamel. J Ultrastruct Res 1963;8:12-23.1401318410.1016%2FS0022-5320%2863%2980017-9
Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC: Remineralization of enamel subsurface lesions by sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. J Dent Res 2001;80:2066-2070.1180876310.1177%2F00220345010800120801
Baig AA, Fox JL, Young RA, Wang Z, Hsu J, Higuchi WI, Chhettry A, Zhuang H, Otsuka M: Relationships among carbonated apatite solubility, crystallite size, and microstrain parameters. Calcif Tissue Int 1999;64:437-439.1020342110.1007%2Fs002239900628
Reynolds EC: Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: A review. Spec Care Dentist 1998;8:8-16.979130210.1111%2Fj.1754-4505.1998.tb01353.x
Reynolds EC, Black CL, Cai F, Cross KJ, Eakins D, Huq NL, Morgan MV, Nowicki A, Perich JW, Riley PF, Shen P, Talbo G, Webber FW: Advances in enamel remineralization: Anticariogenic casein phosphopeptide - amorphous calcium phosphate. J Clin Dent 1999;10:86-88.
Reynolds EC: Remineralization of enamel sub-surface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res 1997;76:1587-1595.929449310.1177%2F00220345970760091101
Reynolds EC, Cai F, Shen P, Walker GD: Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. J Dent Res 2003;82:206-211.1259855010.1177%2F154405910308200311
Reynolds EC, Cain CJ, Webber FL, Black CL, Riley PF, Johnson IH, Perich JW: Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res 1995;74:1272-1279.762933610.1177%2F00220345950740060601
Sokal RR, Rohlf FJ: Biometry. San Francisco, Freeman, 1969.
Nelson DG: The influence of carbonate on the atomic structure and reactivity of hydroxyapatite. J Dent Res 1981;60:1621-1629.6943172
Shellis RP, Lee AR, Wilson RM: Observations on the apparent solubility of carbonated-apatites. J Colloid Interface Sci 1999;218:351-358.1050236610.1006%2Fjcis.1999.6407
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References_xml – reference: White DJ: Use of synthetic-polymer gels for artificial carious lesion preparation. Caries Res 1987;21:228-242.347134610.1159%2F000261026
– reference: Shellis RP, Lee AR, Wilson RM: Observations on the apparent solubility of carbonated-apatites. J Colloid Interface Sci 1999;218:351-358.1050236610.1006%2Fjcis.1999.6407
– reference: Baig AA, Fox JL, Young RA, Wang Z, Hsu J, Higuchi WI, Chhettry A, Zhuang H, Otsuka M: Relationships among carbonated apatite solubility, crystallite size, and microstrain parameters. Calcif Tissue Int 1999;64:437-439.1020342110.1007%2Fs002239900628
– reference: Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC: Remineralization of enamel subsurface lesions by sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. J Dent Res 2001;80:2066-2070.1180876310.1177%2F00220345010800120801
– reference: Reynolds EC, Cai F, Shen P, Walker GD: Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. J Dent Res 2003;82:206-211.1259855010.1177%2F154405910308200311
– reference: Sokal RR, Rohlf FJ: Biometry. San Francisco, Freeman, 1969.
– reference: Reynolds EC, Cain CJ, Webber FL, Black CL, Riley PF, Johnson IH, Perich JW: Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res 1995;74:1272-1279.762933610.1177%2F00220345950740060601
– reference: Reynolds EC: Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: A review. Spec Care Dentist 1998;8:8-16.979130210.1111%2Fj.1754-4505.1998.tb01353.x
– reference: Malcolm AS: A microradiographic apparatus. Aust Dent J 1972;17:454-460.451198210.1111%2Fj.1834-7819.1972.tb04977.x
– reference: Reynolds EC, Black CL, Cai F, Cross KJ, Eakins D, Huq NL, Morgan MV, Nowicki A, Perich JW, Riley PF, Shen P, Talbo G, Webber FW: Advances in enamel remineralization: Anticariogenic casein phosphopeptide - amorphous calcium phosphate. J Clin Dent 1999;10:86-88.
– reference: Nelson DG: The influence of carbonate on the atomic structure and reactivity of hydroxyapatite. J Dent Res 1981;60:1621-1629.6943172
– reference: Reynolds EC: Remineralization of enamel sub-surface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res 1997;76:1587-1595.929449310.1177%2F00220345970760091101
– reference: Angmar B, Carlström D, Glas JE: Studies on the ultrastructure of dental enamel. J Ultrastruct Res 1963;8:12-23.1401318410.1016%2FS0022-5320%2863%2980017-9
– reference: LeGeros RZ, Sakae T, Bautista C, Retino M, LeGeros JP: Magnesium and carbonate in enamel and synthetic apatites. Adv Dent Res 1996;10:225-231.920634110.1177%2F08959374960100021801
– ident: ref8
  doi: 10.1177%2F00220345950740060601
– ident: ref9
  doi: 10.1006%2Fjcis.1999.6407
– ident: ref11
  doi: 10.1159%2F000261026
– ident: ref3
  doi: 10.1177%2F08959374960100021801
– ident: ref1
  doi: 10.1016%2FS0022-5320%2863%2980017-9
– ident: ref5
  doi: 10.1177%2F00220345970760091101
– ident: ref6
  doi: 10.1111%2Fj.1754-4505.1998.tb01353.x
– ident: ref2
  doi: 10.1007%2Fs002239900628
– ident: ref4
  doi: 10.1111%2Fj.1834-7819.1972.tb04977.x
– ident: ref7
  doi: 10.1177%2F154405910308200311
– ident: ref10
  doi: 10.1177%2F00220345010800120801
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Snippet The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein...
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SubjectTerms Acetic Acid - pharmacology
Adult
Cariostatic Agents - therapeutic use
Caseins - therapeutic use
Chewing Gum
Cross-Over Studies
Dental Enamel - drug effects
Double-Blind Method
Female
Humans
Male
Middle Aged
Original Paper
Tooth Demineralization - therapy
Tooth Remineralization - methods
Xylitol
Title Acid Resistance of Enamel Subsurface Lesions Remineralized by a Sugar-Free Chewing Gum Containing Casein Phosphopeptide-Amorphous Calcium Phosphate
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Volume 38
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