An interventional study of Swept-Source Optical Coherence Tomography (SS-OCT) and Orange Juice Erosive Challenge in Dental Erosion and Erosive Tooth Wear, sponsored by University of Malaya. Completed. Open to participants aged 22 Years to 33 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-08.
Sponsored by University of Malaya · Not applicable, Interventional, and Diagnostic
This study aims to evaluate the ability of swept-source optical coherence tomography (SS-OCT) to detect early enamel optical changes associated with erosive tooth wear under clinically relevant in vivo conditions. The study also investigates whether salivary stimulation induced by sugar-free chewing gum influences enamel optical properties following repeated erosive challenges.
A prospective, longitudinal, within-subject study with a fixed-sequence design was conducted. Twenty-two healthy adults aged 23-33 years participated after meeting predefined inclusion and exclusion criteria. All participants completed two sequential experimental phases separated by a two-day washout period. A fixed-order design (Phase A followed by Phase B) was selected to standardize erosive exposure and minimize variability during repeated intraoral OCT measurements. As an exploratory study, randomization was not performed.
In both phases, participants underwent repeated erosive challenges using commercially available orange juice (pH 3.4). During each challenge, participants swished 25 mL of orange juice for 30 seconds followed by a 30-second rest interval, repeated continuously for 10 minutes (total exposure: 250 mL). Erosive challenges were performed three times daily at three-hour intervals over three consecutive days under investigator supervision.
Phase A consisted of repeated erosive challenges without intervention. In Phase B, participants followed the identical erosive protocol but chewed sugar-free chewing gum for 15 minutes immediately after each erosive challenge to stimulate salivary flow and enhance natural buffering and remineralization mechanisms.
All participants used standardized fluoridated toothpaste and soft-bristled toothbrushes beginning two days before the study and throughout the experimental period. Unstimulated salivary flow rate was measured before enrolment, and participants with salivary flow rates below 0.2 mL/min were excluded.
The primary outcome measure was enamel integrated reflectivity (IR), quantified from SS-OCT A-scan analysis as an indicator of enamel optical changes associated with early demineralization. A commercially available swept-source OCT system equipped with an intraoral probe was used for image acquisition. The middle third of the labial surface of the maxillary right central incisor (tooth 11) served as the standardized imaging site. Custom acrylic positioning devices and anatomical landmarks were used to improve reproducibility of repeated measurements.
SS-OCT imaging was performed at six standardized time points during each study day: baseline before the first erosive challenge (t1), after the first challenge (t2), after the second challenge (t3), after the third challenge (t4), following a three-hour rest period (t5), and the following morning after overnight salivary exposure (t6). Image acquisition parameters, drying procedures, and positioning were standardized for all participants.
Integrated reflectivity values were calculated from predefined regions of interest using established OCT image analysis methods. Five adjacent A-scans were averaged to reduce signal noise. Statistical analyses included paired sample t-tests for predefined comparisons and linear mixed-effects modelling to evaluate longitudinal changes while accounting for repeated measurements within participants. Statistical significance was set at α = 0.05.
The study was approved by the appropriate institutional ethics committee, and written informed consent was obtained from all participants before enrolment. The study complied with the principles of the Declaration of Helsinki. Findings are expected to provide evidence regarding the feasibility of SS-OCT as a non-invasive clinical tool for monitoring early erosive enamel changes and evaluating preventive interventions under clinically relevant oral conditions.
47 studies on the registry are indexed under Tooth Erosion; 7 are open to participants now.
This study's enrollment of 22 is below the median of 33 across 33 interventional studies indexed under Tooth Erosion.
Browse Tooth Erosion studies →University of Malaya is the lead sponsor of 284 studies on the registry; 58 are open to participants now.
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Healthy adults aged 23-33 years. Presence of intact maxillary right central incisor (tooth 11) suitable for repeated SS-OCT imaging.
Good general and oral health. Normal unstimulated salivary flow rate (≥0.2 mL/min). Willingness to comply with all study procedures, including repeated erosive challenges and SS-OCT examinations.
Provision of written prior to participation.-
Exclusion Criteria:
Presence of active dental caries, restorations, enamel defects, cracks, or erosive lesions on the study tooth.
Ongoing orthodontic treatment affecting the study tooth. History of systemic diseases or medications known to affect salivary flow or enamel mineralization.
Unstimulated salivary flow rate \<0.2 mL/min. Pregnancy or breastfeeding. Known allergy or intolerance to orange juice or sugar-free chewing gum. Current smokers or tobacco users. Inability or unwillingness to comply with study procedures or attend all scheduled visits.
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants underwent two sequential experimental phases in a fixed-order design. During Phase A, participants received repeated orange juice erosive challenges without chewing gum stimulation for three consecutive days. Following a two-day washout period, all participants completed Phase B, during which the identical erosive challenge protocol was repeated with 15 minutes of sugar-free chewing gum immediately after each erosive challenge. Swept-source optical coherence tomography (SS-OCT) imaging was performed repeatedly throughout both phases to monitor enamel optical changes. Each participant served as his or her own control.
Diagnostic Test: Swept-Source Optical Coherence Tomography (SS-OCT) · Other: Orange Juice Erosive Challenge · Behavioral: Sugar-Free Chewing Gum Stimulation
A commercially available swept-source optical coherence tomography (SS-OCT) system (OCS1300SS, Thorlabs Inc., USA) equipped with an intraoral probe was used to obtain non-invasive cross-sectional images of enamel. The labial surface of the maxillary right central incisor was imaged under standardized conditions at six time points per day during each 3-day experimental phase to quantify enamel integrated reflectivity.
Participants swished 25 mL of commercially available orange juice (pH 3.4) for 30 seconds followed by a 30-second rest interval. This cycle was repeated continuously for 10 minutes (total exposure: 250 mL per session). The erosive challenge was performed three times daily at 3-hour intervals for three consecutive days during both experimental phases.
During Phase B, participants chewed one piece of sugar-free chewing gum (Wrigley's Extra® Peppermint) for 15 minutes immediately after each orange juice erosive challenge to stimulate salivary flow. This intervention was repeated after each of the three daily erosive challenge sessions over three consecutive days.
Change in enamel integrated reflectivity measured by swept-source optical coherence tomography (SS-OCT)
Description Integrated reflectivity (IR), derived from SS-OCT A-scan analysis, will be used to quantify changes in enamel backscattered light intensity associated with early erosion-related optical alterations. Higher IR values indicate increased optical scattering consistent with enamel demineralization.
Time frame: Baseline through Day 3 of each study phase (6 measurements per day over two 3-day experimental phases).
Longitudinal changes in enamel integrated reflectivity during repeated erosive challenges
Longitudinal changes in integrated reflectivity will be evaluated using repeated SS-OCT measurements and linear mixed-effects modelling to assess cumulative enamel optical changes over time and between experimental phases.
Time frame: Baseline through Day 3 of each experimental phase.
No study locations are listed for this record.
Plan to share: No — Do not intend to make de-identified individual participant data publicly available. The ethics approval and participant consent did not include provisions for sharing individual participant data. Data will only be available upon reasonable request or not at all.
No publications or documents are linked to this record.
Ran from Jun 2016 to primary completion in Jun 2016, 0 months.
Of 20 interventional studies with no phase under Tooth Erosion, half reached primary completion within 6 months of starting (the median), counting those still running; a quarter within 1 and three quarters within 28. This study's 0 months is below that.
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This study is completed, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.
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