In situ effect of a commercial CPP-ACP chewing gum on the human enamel initial erosion

Abstract Objective This study evaluated the in situ rehardening effect of a commercial chewing gum containing casein phosphopeptide – amorphous calcium phosphate (CPP-ACP) on initial erosion lesions. Methods Seventy-two human enamel blocks, after selection (initial surface hardness – SH i ) and in vitro short-term acidic exposure (cola drink for 3 min – SH d ) were randomly assigned to three groups. The factors under study were treatment (3 levels: GI chewing gum with CPP-ACP, GII chewing gum without CPP-ACP and GIII control group without gum) and intraoral period (2 levels: 2 and 24 h). Twelve volunteers wore intraoral palatal devices for 24 h in 3 crossover phases. On each phase, after 2 h the surface hardness was assessed (SH f 1) and the blocks were reinserted and the devices were used for additional 22 h (SH f 2). In phases of GI and GII volunteers chewed the respective gum during 30 min, for 4 times with an interval of 4 h. Percentage of surface hardness recovery (%SHR) was calculated after 2 and 24 h. The data were analysed by repeated measures ANOVA and Tukey's test. Results Chewing gum with CPP-ACP (2 h = 50.0% < 24 h = 95.9%) showed higher hardness recovery than chewing gum without CPP-ACP (2 h = 30.0% < 24 h = 71.1%) and control (2 h = 15.7% < 24 h = 40.9%) ( p < 0.05). Conclusions The results suggest that saliva increased hardness of softened enamel after the use of conventional chewing gum (GII) and this effect was enhanced by the prolonged intraoral period (24 h) and by the use of CPP-ACP chewing gum (GI). Clinical significance Since chewing gum is an alternative to enhance salivary defenses after erosive challenges, CPP-ACP chewing gum might be a supplementary strategy to potentiate the mineral precipitation of initial erosion lesions.