Effects of a chewing gum containing phosphoryl oligosaccharides of calcium (POs-Ca) and fluoride on remineralization and crystallization of enamel subsurface lesions in situ

• Published in: Journal of dentistry Vol. 39; no. 11; pp. 771 - 779
• Main Authors: Kitasako, Yuichi, Tanaka, Miyuki, Sadr, Alireza, Hamba, Hidenori, Ikeda, Masaomi, Tagami, Junji
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.11.2011; Elsevier; Elsevier Limited
• Subjects: Adult; Animals; Bioavailability; Biological and medical sciences; Biological Availability; Calcium; Calcium additives; Calcium Compounds - pharmacokinetics; Cattle; Chewing Gum; Crystal lattices; Crystallization; Crystallography, X-Ray - methods; Dental Caries - metabolism; Dental Caries - pathology; Dental Enamel - metabolism; Dental Enamel - pathology; Dentistry; Double-Blind Method; Drinking water; Durapatite - analysis; Enamel; Enamel subsurface lesion; Ent. Stomatology; Female; Fluoride; Fluorides; Fluorides - pharmacokinetics; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; In situ; Male; Maxillofacial surgery. Dental surgery. Orthodontics; Medical sciences; Microradiography; Oligosaccharides - pharmacokinetics; Organophosphates - pharmacokinetics; Pharmacology. Drug treatments; Phosphates - pharmacokinetics; Statistics, Nonparametric; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tooth Remineralization - methods; Young Adult; Chewing gum; Enamel subsurface lesion; Calcium additives; Fluoride; In situ; Human; Calcium; Oligosaccharide; Crystallization; Dentistry; Fluorides; Biological activity; Tooth enamel; Additive; Randomization; Calcium compound; Double blind study; Remineralization
• ISSN: 0300-5712; 1879-176X; 1879-176X
• DOI: 10.1016/j.jdent.2011.08.009

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. 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. 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). 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).