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

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.

White Spot Lesions: Prevention and Management During the Orthodontic Treatment

“…CPP-ACP has been shown to adhere to the bacterial wall of microorganisms and tooth surfaces [37]. When an intraoral acid attack occurs, the calcium and phosphate ions are released to produce a supersaturated concentration of ions in the saliva, which then precipitates a calcium-phosphate compound onto the exposed tooth surface [38]. A few studies showed that daily applications of the remineralizing cream could reverse the severity and visual appearance of postorthodontic WSLs more effectively than fluoride toothpaste.…”

Comparative Evaluation of Shear Bond Strength of Orthodontic Brackets on Pretreatment with CPPACP, Fluor Protector and Phosflur: An In-vitro Study

“…Orthodontic appliances as such are not a cause of demineralization or caries, but creation of new retentive sites could result in oral hygiene problems when Orthodontic appliances are worn [10].…”

Ağiz Sağliği Bi̇li̇nci̇ Ve Ortodonti̇ Hastalarinin Ağiz Sağliğinin Geli̇şti̇ri̇lmesi̇

“…Yapılan çalışmalarda sakız içerisine eklenen CPP-ACP nin remineralizasyonu zenginleştirdiği gözlenmiştir. Ancak bu durumun CPP-ACP'den mi kaynaklandığı yada sakızların kullanımıyla tükürük uyarılmasından dolayı mı kaynaklandığı soru işaretidir 70,71 . Şekersiz sakız kullanımı genellikle sabit ortodontik apareylerin kullanılmasından sonra tavsiye edilmektedir.…”