Comparative Efficacy of Novel Biomimetic Remineralising Technologies

Abstract

Biomimetic technologies for the remineralisation of enamel subsurface lesions (ESLs) have been developed and include: fluorocalcium phosphosilicate bioglass (BG/F); casein phosphopeptide-amorphous calcium phosphate (CPP–ACP) and with fluoride (CPP–ACFP); and self-assembling oligopeptide P11-4 (SAP). The aim of this study was to compare the remineralisation of ESLs in vitro using these technologies. Human enamel slabs with ESLs were cut into two half-slabs; one half-slab was untreated (control), and the other half was treated by exposure to one of the four technologies with artificial saliva (AS) or AS alone for 14 days at 37 °C. The technologies were applied to the ESL surface according to the manufacturer’s instructions. At the completion of each treatment, the treated half-slabs and their paired control half-slabs were embedded, sectioned and the mineral content was determined using transverse microradiography. The change in mineral content (remineralisation) between treatments was statistically analysed using one-way ANOVA. The order from highest to lowest remineralisation was CPP–ACFP (52.6 ± 2.6%) > CPP–ACP (43.0 ± 4.9%) > BG/F (13.2 ± 2.5%) > SAP (5.8 ± 1.6%) > AS (2.1 ± 0.5%). Only CPP–ACFP and CPP–ACP produced remineralisation throughout the body of the lesions. All four biomimetic technologies had some effect on the remineralisation of ESLs; however, CPP–ACFP with calcium, phosphate and fluoride ions stabilised by CPP was superior in the level and pattern of remineralisation obtained.

Development and effect of orodispersible film incorporated with Biosilicate for remineralization of dental enamel subjected to cariogenic and erosive challenge

“…41 Studies [38][39][40] show that there is a point beyond which the buffering capacity of saliva becomes less effective in the dental remineralization process, thus requiring external assistance to restore oral conditions and DE/RE process balance. [42][43][44] The mechanism of action of Biosilicate occurs through the formation of silica gel, which occurs precisely in the presence of saliva. Thus, Biosilicate acts by amplifying, to some extent, the role of saliva, which is more clearly evident in the DE/RE process, while reducing the mineral recovery time after contact with demineralizing substances, without disrupting this system at the expense of dental structure.…”

“…Thus, Biosilicate acts by amplifying, to some extent, the role of saliva, which is more clearly evident in the DE/RE process, while reducing the mineral recovery time after contact with demineralizing substances, without disrupting this system at the expense of dental structure. 44,45 Biosilicate is one of the most promising alternatives to Bioglass 45S5 in terms of bioactivity, osteoconductivity, osteoinductivity, as well as non-cytotoxicity and antibacterial properties. 45 Additionally, in monolithic form, it is quite strong and resistant, and its in vitro bioactivity is similar to, and in some aspects superior to, the gold standard Bioglass 45S5, proving to be a very versatile, multifunctional, and promising biomaterial within preventive Dentistry.…”

“…The remineralization potential of saliva is effective up to a certain point, considering the time of cariogenic and erosive challenge to which dental structures are being subjected 41 . Studies 38–40 show that there is a point beyond which the buffering capacity of saliva becomes less effective in the dental remineralization process, thus requiring external assistance to restore oral conditions and DE/RE process balance 42–44 …”

“…The mechanism of action of Biosilicate occurs through the formation of silica gel, which occurs precisely in the presence of saliva. Thus, Biosilicate acts by amplifying, to some extent, the role of saliva, which is more clearly evident in the DE/RE process, while reducing the mineral recovery time after contact with demineralizing substances, without disrupting this system at the expense of dental structure 44,45 …”

Comparative evaluation of remineralization potential of novel bioactive agents on eroded enamel lesions: A single-blinded in vitro study

“…In the pursuit of new treatment strategies, biomimetic self-assembling peptides (SAPs) stand out as a promising option due to their high affinity to calcium and diffusion capability into the subsurface micropores of enamel. [ 10 ] However, literature-based evidence that point toward its properties in the prevention of demineralization, in addition to repair of demineralized subsurface lesions is a lacunae yet to be filled.…”