Abstract
Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is able to increase salivary calcium and phosphate levels at an acidic pH. Previous studies demonstrated that a CPP-ACP chewing gum was able to enhance the re-hardening of erosion lesions, but could not diminish enamel hardness loss. Therefore, there is no consensus regarding the effectiveness of CPP-ACP on dental erosion. ObjectiveThis in situ study investigated the ability of a CPP-ACP chewing gum in preventing erosive enamel loss. Material and Methods: During three experimental crossover phases (one phase per group) of seven days each, eight volunteers wore palatal devices with human enamel blocks. The groups were: GI – Sugar free chewing gum with CPP-ACP; GII – Conventional sugar free chewing gum; and GIII – No chewing gum (control). Erosive challenge was extraorally performed by immersion of the enamel blocks in cola drink (5 min, 4x/day). After each challenge, in groups CPP and No CPP, volunteers chewed one unit of the corresponding chewing gum for 30 minutes. Quantitative analysis of enamel loss was performed by profilometry (µm). Data were analyzed by Repeated-Measures ANOVA and Tukey’s test (p<0.05).ResultsThe use of chewing gum (CPP and No CPP) resulted in lower erosive enamel loss compared with the control group (p<0.05). CPP-ACP chewing gum (CPP) did not improve the protection against erosive enamel loss compared with conventional chewing gum (No CPP) (p>0.05).ConclusionThe CPP-ACP chewing gum was not able to enhance the anti-erosive effect of conventional chewing gum against enamel loss.
Highlights
Tooth wear is a progressive and multifactorial process in which erosion, attrition, and abrasion may synergistically act 25
The ideal prevention and control of erosive tooth wear involves the removal of causal factors
Promising results were obtained from studies that evaluated the casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) remineralizing capacity on eroded lesions[1,16,17,19]
Summary
Tooth wear is a progressive and multifactorial process in which erosion, attrition, and abrasion may synergistically act 25. The control of dental erosion requires a combination of strategies that includes the reduction on the frequency of erosive challenges and the enhancement of salivary defenses[12] The latter can be achieved, among other ways, by the use of chewing gum22,QDGGLWLRQWKHUDSLHVLQFOXGLQJÀXRULGH applications, in high-concentration, acidic formulations DQGSRO\YDOHQWVRXUFHVOLNHDVVWDQQRXVÀXRULGHKDYH been described to yield positive results in erosive treatment[8]. An in situ study showed that the use of chewing gum immediately before a short erosive demineralization was able to diminish enamel hardness loss, the presence of CPP-ACP in the chewing gum could not enhance this protective effect[10]. The null hypothesis tested was that there would be no difference between the CPP-ACP chewing gum and a conventional sugar free chewing gum in reducing erosive enamel loss
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