Remineralization Of Lesions Research Articles

Remineralization of Artificial Dentin Lesions via the Polymer-Induced Liquid-Precursor (PILP) Process.

Acid-etched dentin samples with a zone of demineralized dentin were remineralized via the polymer-induced liquid-precursor (PILP) process. Poly-L-aspartic acid was used as the polymeric process-directing agent. Samples were incubated in the mineralization solution for 1-4 weeks. Dentin samples remineralized by the PILP process presented a surface morphology very similar to the intact mineralized dentin's architecture, in contrast to samples mineralized via the conventional nucleation and growth method (without polymer additive), which led to a superficial crust of randomly organized mineral crystals. Energy dispersive x-ray spectroscopy analysis of the PILP-mineralized samples showed the presence of calcium and phosphate ions at high levels. Since no hydroxyapatite (HA) clusters were observed on the surface of the PILP-mineralized samples, we could conclude the signal was produced from the mineral embedded within the dentin matrix. TEM and diffraction analyses suggest that both intrafibrillar and interfibrillar remineralization occurred in the demineralized dentin matrix.

Comparison of the remineralizing potential of child formula dentifrices

Although child formula fluoridated dentifrices can be used safely by young children their remineralizing capability remains questionable. To evaluate the remineralizing potential of child formula dentifrices on primary teeth. In vitro single-section technique utilizing a 7 days pH-cycling model. Primary teeth were placed in demineralizing solution for 96 h to produce artificial carious lesions 100 μm deep, and then cut longitudinally into 50 sections 100-150 μm thick and randomly assigned to five groups. Sections in Groups A to D were treated with dentifrices containing 500 ppm AmF, 500 ppm MFP, 500 ppm MFP and xylitol, or 500 ppm NaF, respectively. Group E sections were treated with a nonfluoridated dentifrice. Lesions were evaluated using polarized light microscopy and microradiography. Group D (500 ppm NaF) sections exhibited a significant decrease in lesion depth, whereas those in Group E (nonF) showed a significant increase in depth (P<0.05, paired t-test). Decrease in lesion progression was observed in Groups A, B and C. The 500 ppm NaF dentifrice demonstrated remineralization of carious lesions by virtue of a significant decrease in lesion depth; whereas dentifrices that contained AmF, MFP and MFP with xylitol decelerated the progression of demineralization.

Effects of casein phosphopeptide amorphous calcium fluoride phosphate paste on white spot lesions and dental plaque after orthodontic treatment: a 3‐month follow‐up

The effects of casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) paste vs. control paste on the remineralization of white spot caries lesions and on plaque composition were tested in a double-blind prospective randomized clinical trial. Fifty-four orthodontic patients, with multiple white spot lesions observed upon the removal of fixed appliances, were followed up for 3 months. Subjects were included and randomly assigned to either CPP-ACFP paste or control paste, for use supplementary to their normal oral hygiene. Caries regression was assessed on quantitative light-induced fluorescence (QLF) images captured directly after debonding and 6 and 12 wk thereafter. The total counts and proportions of aciduric bacteria, Streptococcus mutans, and Lactobacillus spp. were measured in plaque samples obtained just before debonding, and 6 and 12 wk afterwards. A significant decrease in fluorescence loss was found with respect to baseline for both groups and no difference was found between groups. The size of the lesion area did not change significantly over time or between the groups. The percentages of aciduric bacteria and of S. mutans decreased from 47.4 to 38.1% and from 9.6 to 6.6%, respectively. No differences were found between groups. We observed no clinical advantage for use of the CPP-ACFP paste supplementary to normal oral hygiene over the time span of 12 wk.

A comparative evaluation of fluoridated and non-fluoridated mouthrinses using a 5-day cycling enamel erosion model

Objectives To assess the relative protective effect of commercial mouthrinses containing 0-450ppm fluoride on erosion progression in enamel using a simulated 5-day in vitro cycling model with concurrent monitoring of surface microhardness (SMH) and bulk tissue loss. Methods Specimens were randomly assigned to six treatment groups (n=6). The model mimicked morning and evening use with rinse times (30 or 60s) reflecting those prescribed on pack, interspersed with three cycles of demineralisation/remineralisation per simulated day. The latter comprised 1.0% citric acid monohydrate pH3.2 for 300s, with subsequent remineralisation in mucin-free artificial saliva pH7.0 for 120min. SMH was determined by Vickers microindentation and bulk tissue loss using white-light interferometry. Results From the end of day 1, fluoride-containing mouthrinses conferred statistically significant reductions in bulk tissue loss versus fluoride-free rinses (p<0.05), with lesion depth inversely proportional to fluoride concentration. From day 3, the mean lesion depth of specimens treated with the 450 ppm rinse were statistically significantly lower than all comparator treatment groups (p<0.05). Two distinct trends were apparent when comparing SMH changes in groups treated with fluoride-free versus fluoride-containing mouthrinses. In the latter, SMH levelled out over the final three simulated days in contrast to the former whose SMH continued to fall; differences were statistically significant at day 5 (p< 0.05). Conclusions Bulk tissue loss is inversely proportional to fluoride concentration in this cycling model. The plateau in SMH reflects stabilisation of mineral density as the study progresses and the number of fluoride binding sites and consequently uptake increases, in turn leading to enhanced lesion remineralisation.

Lifelong Exposure to Fluoride at 1.1 ppm (1.1 mg/L) in Drinking Water Promotes the Remineralization of Caries Lesions

Prevalence and extent of dental caries, dental fluorosis, and developmental enamel defects in Lithuanian teenage populations with different fluoride exposures. Machiulskiene V, Baelum V, Fejerskov O, Nyvad B. Eur J Oral Sci 2009;117:154-60. Jay Kumar, DDS, MPH The purpose was to describe the occurrence of dental caries, dental fluorosis, and nonfluoride enamel defects in populations with lifelong exposure to 1.1- or 0.3-ppm levels (1.1 mg/L and 0.3 mg/L) of fluoride in drinking water; and to study the association between the prevalence and extent of dental fluorosis, nonfluoride enamel defects, and dental caries. Colgate-Palmolive (USA) provided support to the study with an unrestricted grant. Cross-sectional study Level 3: Other evidence Not applicable

Nanomaterials in preventive dentistry

The prevention of tooth decay and the treatment of lesions and cavities are ongoing challenges in dentistry. In recent years, biomimetic approaches have been used to develop nanomaterials for inclusion in a variety of oral health-care products. Examples include liquids and pastes that contain nano-apatites for biofilm management at the tooth surface, and products that contain nanomaterials for the remineralization of early submicrometre-sized enamel lesions. However, the treatment of larger visible cavities with nanomaterials is still at the research stage. Here, we review progress in the development of nanomaterials for different applications in preventive dentistry and research, including clinical trials.

Effect of saliva substitutes in combination with fluorides on remineralization of subsurface dentin lesions

Saliva substitutes are prescribed to patients suffering from radiation-induced hyposalivation to alleviate oral complaints; however, some available products have shown to demineralize dentin. The purpose of this in vitro study was to evaluate the effects of two saliva substitutes in combination or not with fluoridation on remineralization of bovine dentin subsurface lesions. Dentin specimens were demineralized, and stored in either mineral water (control; volvic, danone), Glandosane (cell pharm), or modified Saliva natura (SN, Medac) for 5 weeks (37° C). The following treatments were applied twice daily (n = 12/group): (1) no treatment; (2) immersion in pure Elmex sensitive mouthrinse (250 ppm F-; 10 min; Gaba); (3) brushing with Duraphat toothpaste (5,000 ppm F-; Colgate)/storage solution slurry (5 s; ratio 1:3); (4) combination of treatments 2 and 3. Differences in mineral parameters before and after storage/treatment were microradiographically evaluated. After 5 weeks, Glandosane-induced a significant demineralization of dentin specimens. The mineral loss of specimens stored in Glandosane was significantly higher compared to all other solutions (p < 0.05), and this side effect was inhibited by the fluoride products (p < 0.05; ANOVA, Tukey). Modified Saliva natura enabled considerable remineralization, and this was significantly increased by daily application of both fluoride products (p < 0.05). Modified Saliva natura has remineralizing properties, while Glandosane is a demineralizing saliva substitute that should only be used with frequently applied fluorides in dentate patients.

Surfactant-modified β-TCP: structure, properties, and in vitro remineralization of subsurface enamel lesions

A hybrid material comprised of beta-tricalcium phosphate (beta-TCP) and sodium lauryl sulfate (SLS) was prepared using a mechanochemical process, examined using particle size analysis, IR spectroscopy, (31)P, (23)Na, and (13)C solid-state NMR spectroscopy, and calcium dissolution experiments, and probed for in vitro remineralization of subsurface enamel lesions. Our results suggest that while the (31)P environments of beta-TCP remain unchanged during solid-state processing, there is noticeable shifting among the SLS (23)Na and (13)C environments. Therefore, given the structure of beta-TCP, along with our IR examinations and calcium dissolution isotherms, SLS appears to interface strongly with the cation deficient C(3) symmetry site of the beta-TCP hexagonal crystal lattice with probable emphasis placed on the underbonded CaO(3) polyhedra. To demonstrate the utility of the surface-active TCP material in dental applications, we combined the TCP-SLS with 5,000 ppm F (NaF) and evaluated the remineralization potential of subsurface enamel lesions via an in vitro remineralization/demineralization pH cycling dental model. Using surface and longitudinal microhardness measurements, the TCP-SLS plus 5,000 ppm F system was found to significantly boost remineralization of subsurface enamel lesions, with microhardness values increasing up to 30% greater than fluoride alone.

Effect of Galla chinensis on the In Vitro Remineralization of Advanced Enamel Lesions

AimThe effect of Galla chinensis on de-/re-mineralization of advanced enamel lesions was investigated by using micro-CT in a prolonged in vitro experiment.MethodologyBaseline mineral contents of sound enamels were first analyzed. Then lesions were produced in an acidic buffer solution (2.2 mmol·L−1 Ca(NO3)2, 2.2 mmol·L−1 KH2PO4, and pH=4.5) for 21 days, with thrice daily three-minute treatments, divided into four groups: Group A, 4 000 ppm crude aqueous extract of Galla chinensis (GCE); Group B, 4 000 ppm gallic acid; Group C, 1 000 ppm F aq. (as NaF, positive control); Group D, deionized water (negative control). Next, the blocks were immersed in a remineralization solution (1.5 mmol·L−1 CaCl2, 0.9 mmol·L−1 KH2PO4, 0.1 ppm F, and pH=7.0) for 200 days. Mineral loss (ML) in each region of interest(ROI) and integrated mineral loss (IML) of the lesions were calculated (comparing with baseline mineral content of sound enamel) at different time points.ResultsAfter 21 days demineralization, fluoride treatment showed a statistically significant demineralization-inhibiting effect among the four groups, and after 200 days of remineralization, mineral content recovery was ordered (lowest to highest) as A=C<B<D.ConclusionGCE could slow down the remineralization of enamel in the surface layer and thereby facilitate ion transport into the lesion body. The mechanism of Galla chinensis in enhancing the remineralization of dental caries is different from fluoride.

Sugar alcohols, caries incidence, and remineralization of caries lesions: a literature review.

Remineralization of minor enamel defects is a normal physiological process that is well known to clinicians and researchers in dentistry and oral biology. This process can be facilitated by various dietary and oral hygiene procedures and may also concern dentin caries lesions. Dental caries is reversible if detected and treated sufficiently early. Habitual use of xylitol, a sugar alcohol of the pentitol type, can be associated with significant reduction in caries incidence and with tooth remineralization. Other dietary polyols that can remarkably lower the incidence of caries include erythritol which is a tetritol-type alditol. Based on known molecular parameters of simple dietary alditols, it is conceivable to predict that their efficacy in caries prevention will follow the homologous series, that is, that the number of OH-groups present in the alditol molecule will determine the efficacy as follows: erythritol ≥ xylitol > sorbitol. The possible difference between erythritol and xylitol must be confirmed in future clinical trials.

In vivo remineralization of artificial enamel carious lesions using a mineral-enriched mouthrinse and a fluoride dentifrice: A polarized light microscopic comparative evaluation

Remineralization process is accelerated by the presence of fluoride ions in the oral environment, but this mechanism of caries reversal will be further enhanced if the concentration of calcium, phosphate and fluoride ions is supersaturated with respect to that of oral fluids. This in vivo study was carried out to evaluate and compare the remineralizing efficacy of a urea-based mineral-enriched mouthrinse and a fluoridated dentifrice using an in vivo intraoral appliance model and polarized light microscopic evaluation technique. The specimens were prepared from sound teeth and artificial caries was produced using an artificial caries medium in vitro and enamel specimens were inserted in removable orthodontic appliances that were to be worn by 14 children of 10-15 years of age. They were divided into three groups - nonfluoridated dentifrice, fluoridated dentifrice and mineral-enriched mouthrinse groups. After the 6-month experimental period, during which the enamel specimens inserted in the intraoral appliance were subjected to one of the agents (either fluoride, nonfluoride dentifrice or mouthrinse) in vivo, the specimens were retrieved from the patients and were evaluated using the polarized light microscopic technique. On analysis, mineral gain occurred in all groups, viz. nonfluoride dentifrice group, fluoride dentifrice and mineral-enriched mouthrinse group. However, it was found to be complete in the mouthrinse group, i.e. both at the surface and at the subsurface (67%), while in the fluoridated dentifrice group, 43% of the samples showed mineral gain in both zones. In the nonfluoridated dentifrice group also, remineralization occurred but was limited either to the surface or the subsurface zone. Urea-based mineral-enriched mouthrinse was shown to be more efficacious in the process of remineralization of artificial carious lesions.

Effect of Glass Ionomer Cement and Fluoride Varnish on the Remineralization of Artificial Proximal Caries in Situ.

To compare the effect of glass ionomer cement (GIC) and fluoride varnish (F-varnish) on artificial proximal caries in situ. Two 1 x 3 mm2 enamel slabs, divided into three 1 x 1 mm2 windows, were prepared from each proximal surface of 18 premolars. Each slab was distributed into a control area, an intact enamel area and a test area. Artificial lesions were created on the control and test areas by immersing in demineralizing solution for 24 hours. The test windows were either applied with GIC or F-varnish and the full slabs inserted into orthodontic brackets as carriers, which were then bonded to the buccal surfaces of the 6 upper posterior teeth of 6 volunteers using non-fluoride dentifrice for 30 days. There was a 1-week washout period in this crossover study. The middle specimens of the three windows were cross-sectioned to analyze the carious lesion area by a polarized light microscope and calculated with Image-Pro plus software. The average carious lesion area under GIC was significantly less than that under F-varnish (p < 0.05). GIC promotes more remineralization of artificial carious lesions on proximal surfaces than F-varnish.

Therapeutic effect of two fluoride varnishes on white spot lesions: a randomized clinical trial

The aim of this randomized clinical trial study was to evaluate the therapeutic effect of two varnish formulations (G1 = 5% NaF, G2 = 6% NaF + 6% CaF(2)) on the remineralization of white spot lesions (WSL). The sample was composed of 15 (7- to 12-year-old) children with 45 active WSL in anterior permanent teeth. The children were randomly divided into two groups providing 22 lesions for G1 and 23 for G2. The children were submitted to weekly varnish applications 4 times. The WSL were evaluated twice: baseline and on week 4. Maximum lesion dimensions (mesiodistal and incisogingival) were measured in millimeters and classified in four grades of size. WSL were also assessed regarding lesion activity by one calibrated examiner. The Pearson chi-square and Fisher's exact tests were used (P < 0.01). WSL reductions were observed in both varnish groups (Chi-square = 0.15, d.f. = 1, P = 0.90), and with similar magnitude (in mm): 1.19 and 1.29 for G1 and G2, respectively. Thirty-six WSL (15 in G1 and 21 in G2) were classified as inactive on week 4, reaching an overall value of 80%. No difference was observed between G1 and G2 regarding activity scores (Fisher's exact test, p > 0.01). It was concluded that after 4 applications the two varnish formulations tested produced similar clinical effects, indicating the reduction and the control of carious activity in most WSL.

Chemical and crystallographic study of remineralized surface on initial carious enamel treated with Galla chinensis

To investigate the morphologic, chemical and crystallographic characters of remineralized surface on initial carious enamel treated with Galla chinensis, scanning electron microscopy equipped with energy dispersive analysis spectroscopy were used, and X-ray microdiffraction (microzone XRD) was used for the first time to analyze in situ the microzone crystallite of remineralized surface on carious enamel. Bovine sound enamel slabs were demineralized to produce initial carious lesion in vitro. Then, the lesions were exposed to a pH-cycling regime for 12 days of remineralization. Each daily cycle included 4x1 min applications with one of the three treatments: distilled and deionized water (DDW); 1 g/L NaF; 4 g/L G. chinensis extract (GCE). After the treatments, some rod-like deposits and many irregular prominences were found on GCE-treated enamel surface, and the intensities of Ca and P signals showed a tendency to increase; Ca:P ratio was significantly higher than that of DDW-treated enamel. X-ray microdiffraction showed hydroxyapatite was still the main component of GCE-treated enamel, and the crystallinity was increased, the crystal lattice changed gently with decreased lattice parameter a. These results indicated the potential of GCE in promoting the remineralization of initial enamel carious lesions, and supported the previous hypothesis about GCE mechanism. Combined with the anti-bacteria and demineralization inhibition properties of GCE, the natural G. chinensis may become one more promising agent for caries prevention.

Comparison of remineralization effect of three topical fluoride regimens on enamel initial carious lesions

Some studies have been conducted to evaluate the effect of different topical fluoride regimens on the remineralization of initial carious lesions. This study was conducted to compare the effects of 3 topical fluoride treatments on the surface microhardness, fluoride uptake, and fluorescence lesion area in enamel. Forty-eight bovine teeth were demineralized and subjected to one of the following treatments: (1) no treatment (control), (2) iontophoresis using 2% sodium fluoride solution, (3) 1.23% acidulated phosphate fluoride gel application, and (4) 5% sodium fluoride varnish application. Six persons continuously wore a mandibular removable appliance mounted with eight treated bovine teeth orally for 4 weeks, except while eating, sleeping, and brushing. Microhardness of enamel surfaces was measured using a digital microhardness tester. The fluoride concentration was analyzed using a fluoride electrode, and the fluorescence lesion area was calculated by confocal laser scanning microscopy. No significant differences in the microhardness were observed in response to the 3 fluoride regimens. The highest level of fluoride was observed in the APF gel group. APF gel group also showed significantly reduced fluorescence lesion areas compared to those of the control group. The fluoride regimens showed no difference in surface microhardness; although APF gel showed the best effects in terms of fluoride uptake and decrease in the fluorescence lesion area, its effects were not significantly different from those of fluoride varnish.

In vitro effect of fluoride oral hygiene tablets on artificial caries lesion formation and remineralization in human enamel

BackgroundAim of this in-vitro-study was to assess the remineralization potential of a tooth cleaning tablet with different fluoride content.MethodsTwenty three caries free impacted third molars were examined, enamel surfaces were wax coated leaving two 3 × 4 mm windows for exposure to demineralization/remineralization cycles. The teeth were randomly assigned to 4 groups of 5 control and 6 experimental teeth. Demineralization by standardised HEC-gel, pH 4.7 at 37°C for 72 h, was alternated by rinsing in remineralization solution, pH 7.0 at 37°C for 72 h, total challenge time 432 h. The negative control group N was treated during remineralization cycles with saline; positive control group P was treated with remineralization solution; experimental group D1 was exposed to remineralization solution containing Denttabs®-tablets with 1450 ppm F; experimental group D2 was exposed to remineralization solution and Denttabs®-tablets with 4350 ppm F. Each tooth was cut into serial sections and analyzed by polarized light microscopy for assessment of the different zones of white-spot lesions in 3 representative sections. Statistical analysis was based on the Mann-Whitney-Test.ResultsBoth control groups N(-) and P(+) exhibited characteristic white-spot lesions. The remineralization and the demineralization inhibition of the lesions increased considerably from N<P < D1<D2. Denttabs®-2 administration showed partial/total remineralization including lamination and/or disappearance of the body of the lesion. The different results of all 4 groups were statistically highly significant (p < 0.01) with both tests.ConclusionBased on these results the novel Denttabs® formulation represents a highly effective oral hygiene product and the remineralization is correlated to the fluoride content.

Remineralization of enamel subsurface lesions by chewing gum with added calcium

Objectives Chewing sugar-free gum has been shown to promote enamel remineralization. Manufacturers are now adding calcium to the gum in an approach to further promote enamel remineralization. The aim of this study was to compare the remineralization efficacy of four sugar-free chewing gums, two containing added calcium, utilizing a double-blind, randomized, crossover in situ model. Methods The sugar-free gums were: Trident Xtra Care, Orbit Professional, Orbit and Extra. Ten subjects wore removable palatal appliances with four human-enamel half-slab insets containing subsurface demineralized lesions. For four times a day for 14 consecutive days subjects chewed one of the chewing gums for 20 min. After each treatment the enamel slabs were removed, paired with their respective demineralized control slabs, embedded, sectioned and mineral level determined by microradiography. After 1-week rest the subjects chewed another of the four gums and this was repeated until each subject had used the four gum products. Results Chewing with Trident Xtra Care resulted in significantly higher remineralization (20.67 ± 1.05%) than chewing with Orbit Professional (12.43 ± 0.64%), Orbit (9.27 ± 0.59%) or Extra (9.32 ± 0.35%). The form of added calcium in Trident Xtra Care was CPP–ACP and that in Orbit Professional calcium carbonate with added citric acid/citrate for increased calcium solubility. Conclusions Although saliva analysis confirmed release of the citrate and calcium from the Orbit Professional gum the released calcium did not result in increased enamel remineralization over the normal sugar-free gums. These results highlight the importance of calcium ion bioavailability in the remineralization of enamel subsurface lesions in situ.

Remineralization of initial carious lesions in deciduous enamel after application of dentifrices of different fluoride concentrations

The aim of the present study was to evaluate the remineralization potential of five dentifrices with different fluoride concentrations. Initial caries lesions were created in 72 cylindrical enamel blocks from deciduous teeth. The specimens were randomly distributed among six experimental groups corresponding to six experimental periods. Each of the six volunteers carried two deciduous enamel specimens fixed in an intraoral appliance for a period of 4 weeks. They brushed their teeth and the enamel blocks at least two times a day with dentifrices containing 0 ppm (period 1), 250 ppm (period 2), and 500 ppm fluoride (period 3), respectively. A second group of volunteers (n = 6) used dentifrices with a fluoride content of 0 ppm (period 4), 1,000 ppm (period 5), or 1,500 ppm (period 6). At the end of the respective period, the mineral content was determined by transversal microradiography (TMR). The use of dentifrices containing 500 ppm fluoride (38% MR), 1,000 ppm fluoride (42% MR), and 1,500 ppm fluoride (42% MR) resulted in a statistically significant higher mineral recovery compared to the control group (0 ppm fluoride). Mineral recovery was similar after use of dentifrices containing 0 and 250 ppm fluoride (24%; 25%). It is concluded that it is possible to remineralize initial carious lesions in deciduous enamel in a similar way as it has been described for enamel of permanent teeth.

Effect of enamel organic matrix on the potential of Galla chinensis to promote the remineralization of initial enamel carious lesions in vitro

Galla chinensis, a natural traditional Chinese medicine with main composition of tannic acid and gallic acid, is formed when the Chinese sumac aphid Baker (Melaphis chinensis bell) parasitizes the levels of Rhus chinensis Mill. Galla chinensis has shown the potential to enhance the remineralization of initial enamel carious lesion, but the mechanism is still unknown. This study was to investigate whether the enamel organic matrix plays a significant role in the potential of Galla chinensis to promote the remineralization of initial enamel caries. Bovine sound enamel blocks and non-organic enamel blocks were demineralized and exposed to a 12 day pH cycling. During the pH cycling, 30 specimens with the enamel organic matrix were randomly divided into three groups, and treated with 1 g L−1 NaF (group A), 4 g L−1 Galla chinensis extract (group B1) or double deionized water (group C1). Twenty specimens without the enamel organic matrix were randomly divided into two groups, and treated with 4 g L−1 Galla chinensis extract (group B2) or double deionized water (group C2). The integrated mineral loss and lesion depth of all the specimens were analysed by transverse microradiography. The integrated mineral loss and lesion depth of group B1 were less than those of groups B2, C1 and C2, and there were no statistical differences among groups B2, C1 and C2. In conclusion, Galla chinensis can enhance the remineralization of initial enamel carious lesion, and the enamel organic matrix plays a significant role in this potential of Galla chinensis.

Enamel remineralization: controlling the caries disease or treating early caries lesions?

The emphasis currently given to new technologies for enamel remineralization suggests that the changes in the understanding of the dental caries disease, which occurred in the last century, were either not yet adopted or were forgotten. Just like in the past, when the disease was "treated" by restoring cavities, there is presently a misunderstanding on the concept of incipient lesion remineralization. The aim of this paper was to review some concepts about caries, the natural phenomenon of enamel remineralization and the effect of fluoride (F) on it, and also to discuss the clinical relevance of remineralizing products recently launched in the marketplace aiming to "treat early caries lesions".