Anti-cariogenic effect of maltitol chewing gum in situ models

Objectives: The purpose of this study was to evaluate the anti-cariogenic effects of maltitol, compare to the xylitol in sugar-free gum, by investigate the changes of oral flora and remineralize enamel subsurface lesion in a human in situ model.

Methods: The clinical study consisted of 8 weeks, randomized, double blind, cross-over clinical trial. 24 healthy adults (seventeen males, seven females) in a good general and oral health were enrolled in the study. Informed consent and medical history were taken before the experiment. Every subject used the acrylic mandibular removable appliance which was mounted enamel specimens into the recesses of lingual surface and chewed the allocated (maltitol-, xylitol-, sugar and gum base control group ) 2 gum pellets, containing of 1.2g(±0.1g)/piece of maltitol, xylitol or sugar 7 times daily (at 9hr, 11hr, 13hr, 15hr, 17hr, 19hr, 21hr, 2hrs intervals) for 5 mins (total 12 gum pellets per day) between the regular meals. After every test week, there was a 1 week washout period to stabilize the oral conditions.

In order to evaluate the remineralization effect of chewing gum on specimens, we measured Vickers' microhardness, Scanning Electronic Microscope, Confocal Laser Scanning Microscope after gum chewing, 7 days, 21 days, 35 days, 49 days. Results: Vickers' microhardness of experimental chewing gum containing maltitol, xylitol was significantly higher than sugar gum (p=0.000). Surface roughness of experimental chewing gum containing maltitol, xylitol was significantly lower than control (p=0.000). Images of confocal microradiography and SEM of the enamel lesion showed the remineralization effect of gum containing gum base, maltitol, xylitol compared to sugar gum and this data was significant at p<0.001. Conclusions: These results showed that maltitol, xylitol and gum base compare to sugar gum has been more effective in remineralization. It is recommended that maltitol could be used as sugar substitute to prevent dental caries.