Abstract
Human enamel once formed cannot be biologically repaired or replaced. Saliva has a significant role in remineralization of dental enamel. It not only has a buffering capacity to neutralize the oral cavity's low pH generated after acidic encounters, but also acts as a carrier of essential ions, such as fluoride, calcium and phosphate, which have a positive role in enamel's remineralization. This review discusses how salivary contents, like proteins and enzymes, have a natural role in enamel's mineralization. In addition, the presence of ions, such as fluoride, calcium and phosphate, in saliva further enhances its capability to remineralize the demineralized enamel surface. The review further examines modern innovative technologies, based on biomimetic regeneration systems, including dentin phosphoproteins, aspartate-serine-serine, recombinant porcine amelogenin, leucine-rich amelogenin peptide and nano-hydroxyapatite, that promote enamel remineralization. Fluoride boosters like calcium phosphates, polyphosphates, and certain natural products can also play an important role in enamel remineralization.
Highlights
Dental enamel is a calcified tissue that forms the outer protective covering of the anatomical crown of a tooth[1]
Human saliva has a buffering role and acts as a carrier of essential ions that can bring a constructive change in the structure of enamel, promoting remineralization[5]
Saliva contains many important substances and acts as a transporter of many important ions, such as calcium, phosphate and fluoride, which are essential for the promotion of remineralization
Summary
Dental enamel is a calcified tissue that forms the outer protective covering of the anatomical crown of a tooth[1]. This protein is absent in mature enamel, meaning it cannot regenerate[56] Modern systems, such as recombinant porcine amelogenin (rP172) and leucine-rich amelogenin peptide, stabilize calcium phosphate to enhance crystal formation and direct mineral growth respectively[57,58]. Nanohydroxyapatite is another bioactive material that can promote enamel remineralization[53]. It dissolves in aqueous solution to release sodium, calcium, and phosphate ions in the saliva, to which they interact, leading to deposition of a layer of HAP on the enamel’s surface[63] Another major system in the second category is polyphosphate-based systems and among them the most essential is sodium trimetaphosphate (STMP)[64]. More research on remineralizing materials is required as it would significantly decrease incidence of dental caries
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