Enamel Remineralization Research Articles

Synthesis and characterization of hydroxyapatite nanoparticles and their effects on remineralization of demineralized enamel in the presence of Er,Cr: YSGG laser irradiation

BackgroundThis study aims to synthesize and characterize hydroxyapatite nanoparticles (nano-HA) and evaluate their effects on the remineralization of demineralized enamel in the presence to Er,CR: YSGG laser irradiation.Materials and methodsEnamel specimens from 44 human molars were divided into four groups: control, demineralized enamel, demineralized enamel treated with nano-HA, and demineralized enamel treated with nano-HA followed by Er,Cr:YSGG laser irradiation (0.5, 20 Hz, 60 µs, 20 s). Vickers microhardness test was used to evaluate the enamel surface hardness. The morphology and chemistry of enamel surfaces were assessed using scanning electron microscopy (SEM) and Raman spectroscopy, respectively.ResultThe result of this study showed that the application of Er,CR: YSGG laser irradiation to demineralized enamel treated with nano-HA had the highest impact on its microhardness.ConclusionER,CR: YSGG laser irradiation promotes enamel remineralization after treatment with nano HA.

Synthesis and Characterization of Bioactive Glass and Zinc Oxide Nanoparticles with Enamel Remineralization and Antimicrobial Capabilities.

We investigated the effect of bioactive glass and zinc oxide nanoparticles on enamel remineralization, as well as their antimicrobial effect on cariogenic microbes. This is the first study that investigated the properties of bioactive glass and zinc oxide nanoparticles with mixed materials. Fluoride gel (F), bioactive glass microparticles (µB), bioactive glass nanoparticles (nB), zinc oxide nanoparticles (Z), and a mixed suspension of nB and Z (nBZ) were prepared and characterized by scanning and transmission electron microscopy, zeta potential measurement, X-ray diffraction, and acid buffering capacity testing. Further, we performed a remineralization cycle test of 28 days, and nanoindentation testing was carried out during the immersion period, and then the enamel surfaces were examined using scanning electron microscopy. Additionally, the antimicrobial effects of the sample suspensions were evaluated by measuring their minimum microbicidal concentrations against various cariogenic microbes. Our results revealed that nB had a near-circular shape with an amorphous structure and a considerably large specific surface area due to nanoparticulation. Additionally, nB possessed a rapid acid buffering capacity that was comparable to that of μB. In the remineralization test, faster recovery of mechanical properties was observed on the enamel surface immersed in samples containing bioactive glass nanoparticles (nB and nBZ). After remineralization, demineralized enamel immersed in any of the samples showed a rough and porous surface structure covered with mineralized structures. Furthermore, nBZ exhibited a broad antimicrobial spectrum. These results demonstrated that bioactive glass and zinc oxide nanoparticles have superior demineralization-suppressing and remineralization-promoting effects.

Ultrastructural investigation of the effect of toothpastes containing different remineralizing agents on demineralized enamel.

The present study aimed to evaluate the effect of remineralizing agents on demineralized enamel intended for use as fluoride substitutes or supplements for oral hygiene applications. Enamel samples were obtained from 30 bovine teeth. The enamel blocks were stored in 20 mL of demineralization solution for 72 h. They were then brushed with the following toothpaste for the remineralization protocol: NaF, NaF/SnF2 combination, NovaMin, or nano-hydroxyapatite. SEM/EDX examinations and microhardness measurements of the samples were performed to investigate the remineralization efficacy of the studied toothpaste. One-way analysis of variance (ANOVA) with post hoc Tukey's HSD test was used to analyze the change in microhardness values in different remineralization protocols (p < 0.05). Differences in the mean remineralization (%RP) and hardness recovery (%HR) were determined between the groups (p < 0.05). Groups 1 and 4 showed significant differences in %RP (p < 0.05). In the SEM/EDX examinations, the samples treated with n-HAp showed an accumulation of crystal deposits on the enamel surface, although at a lower density than those treated with NaF and NaF/SnF2 combination. The remineralization strategy in toothpaste plays an important role in enamel remineralization. NovaMin-containing toothpaste showed positive effects on the enamel surface with better Ca/P ratio. Toothpastes containing n-HAp triggered less change in the increase of microhardness values compared to other toothpastes. The use of SnF2 in toothpaste in combination with NaF significantly increased the binding of fluoride to demineralized enamel compared to toothpaste containing NaF alone.

Composite materials of amorphous calcium phosphate and bioactive glass nanoparticles for preventive dentistry

Amorphous calcium phosphates and bioactive glasses are two of the most used materials in dentistry thanks to their ability to release remineralizing ions and reduce dentinal hypersensitivity by occluding exposed dentinal tubules. Here, we have synthesized composites of fluoride-doped amorphous calcium phosphate (FACP) and mesoporous bioactive glass nanoparticles (MBGNs) to obtain functional materials that possess both the capability to release dental remineralizing ions of FACP and both the excellent desensitizing activity of MBGNs. The procedure described in this work allows us to obtain FACP/MBGN composites with different compositions (i.e., FACP:MBGN weight ratio) in which the components have formed a deeply intertwined nanostructure. Composites’ ion release (i.e. Ca, P, F, and Si) in acidic artificial saliva is different from that of the single components or their physical mixture, corroborating the formation of composite materials. Moreover, thanks to the presence of FACP, the composites have superior bioactivity than the MBGNs alone. Dental enamel remineralization and efficacy of dentinal tubules occlusion by the investigated composites were preliminarily tested in vitro on human dental hard tissues using scanning electron microscopy. Data revealed that the composites induced a satisfactory remineralization of enamel and dentin thanks to the FACP component, and a positive tubule occlusion thanks to the MBGNs component. Finally, our results demonstrate that FACP/MBGN composites are highly promising materials for preventive dentistry.

Nanohydroxyapatite in enamel remineralization and tooth hypersensitivity

This study evaluates the advantages of employing nano-hydroxyapatite in dentistry, particularly for preventive treatment applications. Only electronically published papers were searched within this review. Sources: "PubMed" website was the only source used to search for data. 92 most relevant papers to the topic were selected, especially the original articles and review papers, from 1990 till the 1st of April 2022. The morphology of nano-hydroxyapatite, as well as the structure of its crystals, are close to that of dental enamel. As a result, hydroxyapatite can biomimetically replace the natural enamel mineral element. Keywords: remineralization of enamel, nanotechnology, nanohydroxyapatite, hypersensitivity.

Nanohydroxyapatite in enamel remineralization and tooth hypersensitivity

This study evaluates the advantages of employing nano-hydroxyapatite in dentistry, particularly for preventive treatment applications. Only electronically published papers were searched within this review. Sources: "PubMed" website was the only source used to search for data. Ninety-two of the most relevant papers were selected, significantly the original articles and review papers, from 1990 till the 1st of April 2022. The morphology of nano-hydroxyapatite, as well as the structure of its crystals, are close to that of dental enamel. As a result, hydroxyapatite can biomimetically replace the natural enamel mineral element. Keywords: remineralization of enamel, nanotechnology, nanohydroxyapatite, hypersensitivity.

Unveiling the mechanism of an amelogenin-derived peptide in promoting enamel biomimetic remineralization

Amelogenin and its derived peptides have exhibited excellent efficacy in promoting enamel biomimetic remineralization. However, little is known about their specific action mechanisms. Herein, by combining experiments and computer simulation, the mechanism of an amelogenin-derived peptide QP5 in regulating enamel biomimetic remineralization is unveiled for the first time. In experiments, peptide QP5 was separated into (QPX)5 and C-tail domains, the interactions of peptide-minerals in nucleation solution and the regulation of peptide on enamel biomimetic remineralization were explored. QP5 exhibited an unordered conformation when mineral ions existed, and it could adsorb on minerals through its two domains, thereby inhibiting spontaneous nucleation. The remineralized enamel regulated by C-tail showed better mechanical properties and formed more biomimetic crystals than that of (QPX)5, indicating the C-tail domain of QP5 played an important role in forming enamel-like crystals. The simulation results showed that the conformation of QP5 changed greatly, mainly exhibiting β-bend, β-turn, and coil structures, and it eventually adsorbed on enamel through negatively charged residues of the C-tail domain, then captured Ca2+ from solution to promote enamel remineralization. This study improved the evaluation methods of the mechanism of biomimetic peptides, and laid a theoretical basis for the amelioration and clinical transformation of peptide QP5.

Polycarboxy/Sulfo Betaine-Calcium Phosphate Hybrid Materials with a Remineralization Potential.

Biomacromolecules control mineral formation during the biomineralization process, but the effects of the organic components' functionality on the type of mineral phase is still unclear. The biomimetic precipitation of calcium phosphates in a physiological medium containing either polycarboxybetaine (PCB) or polysulfobetaine (PSB) was investigated in this study. Amorphous calcium phosphate (ACP) or a mixture of octacalcium phosphate (OCP) and dicalcium phosphate dihydrate (DCPD) in different ratios were identified depending on the sequence of initial solution mixing and on the type of the negative functional group of the polymer used. The more acidic character of the sulfo group in PSB than the carboxy one in PCB determines the dominance of the acidic solid phases, namely, an acidic amorphous phase or DCPD. In the presence of PCB, the formation of ACP with acicular particles arranged in bundles with the same orientation was observed. A preliminary study on the remineralization potential of the hybrid material with the participation of PSB and a mixture of OCP and DCPD did not show an increase in enamel density, contrary to the materials based on PCB and ACP. Moreover, the latter showed the creation of a newly formed crystal layer similar to that of the underlying enamel. This defines PCB/ACP as a promising material for enamel remineralization.

Effectiveness of plant-mediated synthesis of hydroxyapatite nano-particles impregnated in Pistachio oleogum resin on mineral contents of human teeth. An in-situ single-blind controlled study

ObjectivesThis study aimed to synthesize and characterize an environmentally friendly nanohydroxyapatite (n-HA) and evaluate its impact on enamel mineral content when incorporated into a Pistachio oleo gum resin (Saqqez) bio-chewing gum for in-situ models. We compared the effects of this green nano-hydroxyapatite (G n-HA) with those of a commercially available synthetic nano-hydroxyapatite (S n-HA). MethodsVarious analytical techniques were employed including XRD, FESEM, FT-IR, EDX/SEM and TGA/DTA to characterize the crystallinity, size and composition of the G n-HA powder. Three chewing gum groups were formulated: (1) Saqqez gum containing 10% wt G n-HA, (2) Saqqez gum containing 10% wt S n-HA, and (3) pure Saqqez gum. In order to evaluate the impact of these chewing gums on enamel, intraoral appliances were fabricated, each containing six enamel specimens. Participants were instructed to chew the gums while wearing these appliances. The calcium (Ca+2) and phosphorus (P) levels in enamel specimens, both with and without exposure to an acid challenge, were quantified using EDX/SEM. FE-SEM was employed to capture the microstructure of the enamel surface. In terms of the statistical analysis, one-way ANOVA and Tukey's post hoc tests were utilized to compare the data, where the significance level (α) was set at 0.05. ResultsThe characterization tests confirmed the successful synthesis of G n-HA. Furthermore, EDX/SEM analysis of the enamel specimens from the intraoral appliance revealed significant variations in calcium (Ca+2) content among the enamel specimens (P = 0.000). The S n-HA group, in particular, exhibited the highest Ca+2 content, while the pure Saqqez group displayed the lowest. Nonetheless, there was no statistically significant differences in phosphorus (P) content observed among the three groups (P = 0.27). ConclusionsSaqqez gum can be considered a wholesome natural chewing gum that serves, as a carrier for delivering remineralization agents to the tooth surfaces. This was evident in the groups containing n-HA, exhibiting elevated Ca+2 levels. It's noteworthy that G n-HA demonstrated less efficacy in enamel remineralization compared to S n-HA.

The Effect of Different Percentages of Nano-bioactive Glass in the Synthesized CPP/ACP Paste on the Remineralization of Demineralized Enamel

Background: The preventive treatments of primary caries lesions are essential for preventing destructive damage to the tooth structure. One of the common treatments is the application of casein phosphopeptide-amorphous calcium phosphate (CCP/ACP) paste on the enamel surface. The aim of this study was to investigate the effect of different percentages of nano-bioactive glass (nBG) incorporation into synthesized CPP/ACP paste on the remineralization of demineralized enamel. Methods: In general, 24 extracted human intact premolar teeth were selected, and their crowns were removed for this purpose. Each crown was cut into two halves, and each half was considered as a sample. The samples were placed in a demineralizing solution at a pH rate of 4.6 for 8 hours, in artificial saliva for 1 hour, and again in a remineralizing solution at a pH rate of 7 for 15 hours. The pH cycling was performed for 14 days to demineralize the enamel surface. The samples were randomly divided into 3 groups (n=16), including G1 (without treatment), G2 (treated with synthesized CPP/ ACP paste containing 5% nanobioglass), and G3 (treated with synthesized CPP/ACP paste containing 10% nanobioglass). The paste was then placed directly on the surface of the demineralized enamel for 4 minutes (twice a day for 28 days). The samples were subjected to the Vickers microhardness test. Finally, data were analyzed using SPSS (version 19) and the analysis of variance and Tukey’s tests (α = 0.05). Results: There was a significant difference between microhardness values in G1 and G2, as well as G1 and G3 (P&lt;0.05). However, no statistically significant difference was observed between G2 and G3 (P&gt;0.05). Conclusions: The results showed adding bioactive glass into synthetic CPP/ACP paste increases enamel remineralization in spite of the percentage of bioactive glass incorporation.

Enamel remineralization potential and antimicrobial effect of a fluoride varnish containing calcium strontium silicate.

ObjectivesTo investigate enamel remineralization and antimicrobial effect of sodium fluoride (NaF) varnish containing calcium strontium silicate (CSR). MethodsCSR was synthesized by sol-gel process and incorporated in 5 % NaF varnish at three different concentrations (1 %, 2 %, and 4 % w/v). The treatment/control groups were: 1 % CSR+NaF, 2 % CSR+NaF, 4 % CSR+NaF, NaF, and no treatment. Strontium and fluoride release from the varnishes was evaluated. Sound enamel specimens (n = 6) were demineralized, varnish-treated, and subjected to remineralization cycle. Mineral density of enamel specimens was evaluated using micro-CT. Antimicrobial effect of the varnishes on Streptococcus mutans and Lactobacillus acidophilus biofilms was assessed using confocal laser scanning microscopy. The HGF-1 cytotoxicity of the varnishes was examined using CCK-8 assay. ResultsBoth 2 % and 4 % CSR+NaF varnishes showed significantly higher F release and remineralization potential than NaF varnish (p < 0.05). Dead bacterial proportion of 4 % CSR+NaF varnish was significantly higher than NaF varnish (p < 0.05). The CFUs values of both S. mutans and L. acidophilus were significantly lower in 4 % CSR+NaF group than NaF group (p < 0.05). No significant difference in cell viability was observed among the groups (p > 0.05). ConclusionsIncorporation of 4 % CSR in a NaF varnish significantly enhanced its enamel remineralization and antimicrobial potential with no cytotoxic effect. Clinical significanceDental caries is a major public health problem globally. The study highlights the great potential of CSR-doped NaF varnish as a novel anti-caries agent with synergistic remineralizing and antimicrobial properties to combat early enamel caries lesions in the general population.

Remineralization Induced by Biomimetic Hydroxyapatite Toothpastes on Human Enamel.

This work aimed to compare the effect of four new toothpastes (P1-P4) based on pure and biomimetic substituted nano-hydroxyapatites (HAPs) on remineralization of human enamel. Artificially demineralized enamel slices were daily treated for ten days with different toothpastes according to the experimental design. Tooth enamel surfaces were investigated using atomic force microscope (AFM) images and surface roughness (Ra) determined before and after treatment. The surface roughness of enamel slices was statistically analyzed by one-way ANOVA and Bonferroni's multiple comparison test. X-ray diffraction (XRD) and Fourier transform infrared (FTIR) data revealed the HAP structure with crystal sizes between 28 and 33 nm and crystallinity between 29 and 37%. The average size of HAP particles was found to be between 30 and 40 nm. The Ra values indicated that P3 (HAP-Mg-Zn-Sr-Si) toothpaste was the most effective after 10 days of treatment, leading to the lowest mean roughness. The P3 and P2 (HAP) toothpastes were found to be effective in promoting remineralization. Specifically, their effectiveness can be ranked as follows: P3 = P2 > P4 (HAP-Mg-Zn-Si) > P1 (HAP-Zn), considering both the chemical composition and the size of their constitutive nanoparticles. The proposed toothpastes might be used successfully to treat early tooth decay.

A Comparison of the Enamel Remineralisation Potential of Self-Assembling Peptides

The aim of this research was to compare the efficacy of the remineralising potential of self-assembling peptides (SAPs): Curodont Repair (P11-4), P26, and leucine-rich amelogenin peptides (LRAP) with the standard 5% NaF varnish (Duraphat) on early enamel caries lesions (EECLs). A demineralising solution (DS) was used to create artificial EECLs in human dental enamel specimens, which were randomly allocated to treatment groups: P11-4; P26 solution; LRAP solution; 5% NaF varnish; and deionised water (DIW). Each specimen was subjected to 8 days of pH cycling. Specimens from each test group were subjected to microcomputed tomography (micro-CT) and nanomechanical testing to assess mineral density (MD), hardness (H), and elastic modulus (EM) properties of sound, demineralised, and treated enamel. The mean MD percentage gain was highest in the P26 and P11-4 groups, followed by the LRAP, 5% NaF varnish, and DIW groups. There were statistically significant differences amongst groups. In the outer layer of EECLs, the EM and H were highest in P26 and P11-4 groups, followed by the LRAP and 5% NaF varnish. In the inner layer of EECLs, the EM and H were highest in P11-4 and P26 groups, indicative of enhanced penetration and remineralisation of the deeper parts of the artificial EECLs. P26 and P11-4 SAPs are more effective than 5% NaF varnish in remineralising the depth of EECLs.

Effect of the association of microparticles and nano-sized β-calcium glycerophosphate in conventional toothpaste on enamel remineralization: In situ study

ObjectivesThis in situ study aimed to assess the remineralizing effect of a fluoride toothpaste supplemented with β-calcium glycerophosphate in both micro (β-CaGPm) and nano-sized forms (β-CaGPn). MethodsThis blind and cross-over study was performed in 4 phases, each spanning 3 days. Twelve volunteers utilized palatal appliances containing four bovine enamel blocks with artificial caries lesions. Volunteers were randomly assigned to the following treatment groups: Placebo (no F-β-CaGPm-β-CaGPn); 1100 ppm F alone (1100F); 1100F plus 0.5% micrometric β-CaGP (1100F-0.5%β-CaGPm); and 1100F plus 0.25%nano-sized β-CaGP (1100F-0.25%β-CaGPn). Participants were instructed to brush their natural teeth with the palatal appliances in the mouth for 1 min (3 times/day), ensuring that the enamel blocks were exposed to the natural toothpaste slurries. Following each phase, evaluations were conducted to determine the percentage of surface hardness recovery (%SHR), integrated recovery of subsurface hardness (ΔIHR), profile subsurface lesion through polarized light microscopy (PLM), as well as fluoride (F), calcium (Ca), and phosphorus (P) concentrations within the enamel. Data were analyzed by ANOVA and Student-Newman-Keuls test (p < 0.001). ResultsTreatment with 1100F-0.25%β-CaGPn resulted in %SHR ∼69 % and ∼40 % higher when compared to 1100F and 1100F-0.5%β-CaGPm (p < 0.001). The reduction in lesion body (ΔIHR; PLM) was ∼40 % higher with 1100F-0.25%β-CaGPn (p < 0.001) compared to 1100F. The addition of β-CaGPm and β-CaGPn did not influence enamel F concentration (p > 0.001). Treatment with 1100F-0.25%β-CaGPn led to an increase in the concentration of Ca and P in the enamel (p < 0.001). ConclusionThe addition of 0.25%β-CaGPn into 1100F formulation increased the bioavailability of calcium and phosphate, promoting a higher remineralizing effect. Clinical significanceToothpaste containing 1100F-0.25%β-CaGPn showed a potential of higher remineralization to 1100 ppm F and 1100 ppm F micrometric β-CaGP could be a strategy for patients at caries activity.

Enamel Remineralization Efficacy of Coconut Milk and Lyophilized Coconut Extract in Different Concentrations on Demineralized Enamel Surfaces: An In-Vitro Study.

Aim The current study's objective is to determine the remineralizing efficacy of freeze-dried lyophilized coconut extract and coconut milk made from freshly grated coconut on artificial carious lesions produced by pH cycling. Materials and methods Freshly extracted coconut pulp was split into two parts. The first half was blended to obtain coconut milk, and the second part was freeze-dried and lyophilized. Tooth slabs were prepared from extracted third molar teeth. After being demineralized for 72 hours, the tooth samples were remineralized by submerging them in the appropriate remineralizing solution, which is as follows: Group 1 received 25 mL of the Remineralization solution (the control); Group 2 received 2.5 g of coconut milk and 25 mL of the solution (1:1); and Group 3 received 5 g of coconut milk and 25 mL of the solution (2:1). 2.5 g of freeze-dried, lyophilized coconut extract was given to Group 4 along with 25 mL of remineralization solution (1:1), and 5 g of freeze-dried, lyophilized coconut extract was given to Group 5 along with 25 mL of remineralization solution (2:1). Microhardness and contact angle measurements were made. An Excel spreadsheet was filled up with values from after demineralization, and after remineralization. A statistical analysis was performed using SPSS 26.0 (IBM Corp., Armonk, NY). Using descriptive statistics, the pretreatment mean values for the microhardness and contact angle of the various groups were evaluated. Post-hoc Tukey tests were utilized to compare the analytic results of the various groups. Results Among the various concentrations of freshly extracted coconut milk, the contact angle inconcentrations of 1:1 was 81.22 ± 1.62 deg, and that in concentrations of 2:1 was 88.01 ± 1.85 deg. Between the two concentrations of the lyophilized coconut extract group, the contact angle in 1:1 was 75.05 ± 2.29 deg, and in 2:1 was 71.37 ± 0.85 deg. In the coconut milk group, the value of microhardness was 261 ± 6.4 kg/cm2 at a lower concentration and 322 ±3.9 kg/cm2 at a higher concentration. In the lyophilized coconut group, the lower concentration exhibited a microhardness of 211 ±7.2 kg/cm2, whereas in the higher concentration, it was 324 ±4.04 kg/cm2. Conclusion Of the various concentrations of coconut milk and lyophilized coconut used, coconut milk at a higher concentration exhibits the highest contact angle, and the latter at a higher concentration exhibits the lowest contact angle. In both groups, high concentrations of the material exhibited high microhardness values compared to lower concentrations of the same.

A novel orthodontic adhesive containing zinc-doped phosphate-based glass for preventing white spot lesions

ObjectivesThis study aimed at demonstrating the remineralization effect of the enamel around the brackets to aid reduction in white spot lesions (WSLs) with use of zinc-doped phosphate-based glass (Zn-PBG) containing orthodontic adhesives. MethodsZn-PBG powder was synthesized, and particle morphology, size, and density were evaluated. Orthodontic adhesives with increasing loading percentage of Zn-PBG powder were prepared: ZnPG3 (3 wt.%), ZnPG6 (6 wt.%), and ZnPG9 (9 wt.%). Brackets were bonded on the etched enamel surface and stored in distilled water (DW) for 1 h. Following, Shear bond strength (SBS) along with adhesive remnant index were analyzed. The release of calcium (Ca), phosphorus (P), and zinc (Zn) from adhesive specimens in DW was evaluated after 7, 15 and 30 days of immersion. The remineralization effect was confirmed by microhardness and surface morphology analysis with scanning electron microscopy. ResultsThe SBS value was observed between 20 and 22 MPa on enamel surface. The concentration of Ca, P and Zn released in DW increased with loading percentage of Zn-PBG. The microhardness increased in the experimental groups after immersion in artificial saliva for 7 days. Apatite-like crystal formation was observed after 30 days in the ZnPG 9 group. ConclusionsThe orthodontic adhesive containing Zn-PBG with an optimal SBS performance has an enamel remineralization effect, and therefore can aid in prevention of WSLs. Clinical SignificanceThe orthodontic adhesive containing Zn-PBG is clinically advantageous as it can promote remineralization and resist the formation of WSLs that may occur during orthodontic therapy.

Relationship between dentifrices based on hydroxyapatites and human enamel remineralization

Enamel demineralization is an intricate process that holds significant clinical consequences, being a central part of the emergence and progression of various dental problems, most notably dental caries. This demineralization of tooth enamel is linked to a variety of factors, including the composition of oral microbiota and that of saliva, the prevalence of sugar consumption or acidic soft drinks, and, of course, oral hygiene practices. The oral microbiome plays a role in generating organic acids that foster an environment conducive to enamel breakdown. Additionally, a decrease in saliva production can lower the oral environment’s ability to neutralize acids and support the remineralization process, thereby intensifying demineralization. Dentifrices enriched with biomimetic hydroxyapatites are important in preventing demineralization as they not only help with oral hygiene but also provide key ions that help strengthen enamel. Considering their similarity to the natural component in enamel, synthetic hydroxyapatites have recently emerged as potent remineralizing agents. Hence, this work aims to illustrate in a simple and concise manner, some of the aspects involved in enamel demineralization and its subsequent remineralization, namely in the relationship between enriched toothpastes containing biomimetic hydroxyapatites and their remineralization eficacy.

Effectivity of Calcium, Phosphate and Vitamin D in Dental Caries Prevention

Background: Micronutrient elements are vitamins and minerals that are required in small amounts but play important roles in our body. Insufficient micronutrients can affect health including dental health. Objective: Analyzing effectiveness of micronutrients (calcium, phosphorus, and vitamin D) in preventing dental caries. Literature study: This literature study was conducted from Google Scholar, Science Direct, and Pubmed (MEDLINE). The strategy used in literature collection is in the form of writing keywords that are used to find articles to be reviewed with a publication period between 2012 - 2020. Discussion: Dental caries is a demineralization of an inorganic part of the tooth due to a multifactorial etiology and occurs when demineralization exceeds remineralization. The calcium and phosphorus ions level in the saliva could affect the balance between demineralization and remineralization of enamel and its deficiency can strongly influence morphology of the tooth. It has been found that calcium level significantly influences hard dental tissues defense mechanisms. On the other side, vitamin D also plays an important role to form enamel and dentin in the tooth development process because of its receptor in ameloblasts and odontoblasts. Deficiency of vitamin D can cause enamel hypoplasia which is a significant factor for early childhood caries. Conclusions: Calcium, phosphorus, and vitamin D significantly affecting the demineralization and remineralization process. The optimum concentration and level of calcium, phosphorus, and vitamin D in the body effectively increase the tooth defense mechanism and reduce the dental caries.

In vitro evaluation of a novel fluoride-coated clear aligner with antibacterial and enamel remineralization abilities.

To investigate the antibacterial and enamel remineralization performances as well as physicochemical properties and biocompatibility of a fluoride-coated clear aligner plastic (FCAP). FCAP and normal clear aligner plastic (CAP) was bought from the manufacturer (Angelalign Technology Inc, China). The FCAP was observed under scanning electron microscopy. Its element composition, resistance to separation, contact angle, and protein adhesion performance were characterized. Colony-forming unit (CFU) count and 3-(4,5)-dimethylthiazol(-z-y1)-3,5-diphenyltetrazolium bromide (MTT) assay were used to evaluate the antibacterial ability of Streptococcus mutans. Fluoride release-recharge patterns were obtained. Apatite formation was evaluated after immersing FCAP in artificial saliva. Enamel remineralization capability was evaluated in the demineralization model (immersing samples in demineralization solution for 36h) and pH cycling model (immersing samples in demineralization solution and remineralization solution in turns for 14days). Cell Counting Kit-8 (CCK-8) and live/dead cell staining kits were used for cytotoxicity assay. The FCAP showed uniformly distributed fluoride and did not compromise protein adhesion performance. CFU count (5.47 ± 0.55 for CAP, 3.63 ± 0.38 for FCAP) and MTT assay (0.41 ± 0.025 for CAP, 0.28 ± 0.038) indicated that the FCAP had stronger antibacterial activity compared with normal CAP (P < 0.05 for both evaluations). The FCAP could release fluoride continuously for 14days and could be recharged after immersing in NaF solution. The FCAP could induce the formation of hydroxyapatite in artificial saliva and could reduce the microhardness decrease, color change, and mineral loss of enamels in both two models (P < 0.05 for all evaluations). CCK-8 and live/dead cell staining analyses showed that the coating did not compromise the biocompatibility of the clear aligner (P > 0.05 for CCK-8 evaluation). The FCAP had antibacterial, fluoride recharge, and enamel remineralization abilities while it did not compromise physicochemical properties and biocompatibility. The FCAP has the potential to prevent enamel demineralization during clear aligner treatment.

Differences in enamel surface hardness between soaking carbonated drinks and application of duck eggshell paste remineralization material

ABSTRACTIntroduction: The surface hardness of enamel is affected by demineralization and remineralization of enamel. Demineralization can cause the enamel surface hardness to decrease. Carbonated drinks are acidic drinks which can lower the pH of the oral cavity and cause damage to the enamel. Lost tooth minerals can be restored with remineralizing materials, one of which contains calcium. Natural materials that can help remineralization are calcium carbonate (CaCO3) which can be found in several animal shells such as marine materials, pearl snails and eggshells. Duck eggshell is one of the household wastes which is high in calcium which consists of 94% calcium carbonate. The purpose of this study is to analyze differences in enamel surface hardness between soaking carbonated drinks and application of duck eggshell paste remineralization material. Methods: This type of research is a true experimental laboratory with a pretest-posttest research design with control group design. The study sample was 8 post-extraction premolars that matched the inclusion criteria. The samples were divided into two groups which were previously soaked in carbonated drinks for 15 minutes. Group I: duck eggshell paste and group II: pasta without duck eggshell which was applied for 3 minutes 2 times a day for 14 days. Hardness measurement using Vickers hardness tester. Results: based on data analysis using paired t-test. Enamel surface hardness after immersion in carbonated drinks (mean=327.50 SD=23.33). The enamel surface hardness increased after application of duck eggshell paste (mean=467.50, SD=14.15) p=0.001. The control group also increased after the application of pasta without duck eggshell (mean=429.40 SD=29.01) p=0.002. Conclusion: There is a difference in the hardness of the enamel surface after being soaked in carbonated drinks and after the application of duck egg shell paste. KEYWORDSdemineralization, enamel surface hardness, carbonated drinks, duck egg shell paste, remineralization.