Hydroxyapatite in Oral Biofilm Management

Abstract

Particulate hydroxyapatite, Ca5 (PO4)3 (OH), shows a good biocompatibility and is used as a biomimetic ingredient in dental care formulations due to its similarity to human enamel. Numerous studies show its efficiency, for example, in reducing dentin hypersensitivity, and in the remineralization of enamel and dentin. In addition, oral care products with hydroxyapatite improve periodontal health under in vivo conditions. This review article summarizes data on the effects of hydroxyapatite particles in oral biofilm management. Two databases (PubMed and SciFinder) were searched for studies using specific search terms. In contrast to frequently used antibacterial agents for biofilm control, such as chlorhexidine, stannous salts, and quaternary ammonium salts, hydroxyapatite particles in oral care products lead to a reduction in bacterial attachment to enamel surfaces in situ without having pronounced antibacterial effects or showing unwanted side effects such as tooth discoloration. Furthermore, antibacterial agents might lead to dysbiosis of the oral ecology, which was recently discussed regarding pros and cons. Remarkably, the antiadherent properties of hydroxyapatite particles are comparable to those of the gold standard in the field of oral care biofilm management, chlorhexidine in situ. Although biomimetic strategies have been less well analyzed compared with commonly used antibacterial agents in oral biofilm control, hydroxyapatite particles are a promising biomimetic alternative or supplement for oral biofilm management.

In Vitro Whitening Effect of a Hydroxyapatite-Based Oral Care Gel

“…6,9,29 In situ studies show an efficient reduction of bacterial colonization to enamel surfaces by using HAP-based mouth rinses. 18,23,30 This might be also an important factor for tooth whitening since stains are often incorporated into dental plaque. 1 In contrast to the HAP-gel, the tested mouth rinse showed only minor whitening effects in our in vitro setting after one, three, and nine cycles.…”

“…1,[5][6][7][8][9] In particular, biomimetic HAP is inspired by structure and composition of natural enamel crystallites 10 and shows a broad range of applications in preventive oral health care, [11][12][13][14][15][16][17] such as antibiofilm properties. 18 A recently published Eur J Dent Whitening Effect of Hydroxyapatite-Based Oral Care Gel Sarembe et al…”

In Vivo Effects of a Hydroxyapatite-Based Oral Care Gel on the Calcium and Phosphorus Levels of Dental Plaque

“…Due to its high similarity to human enamel crystallites, particulate hydroxyapatite (HAP, Ca 5 (PO 4 ) 3 (OH)) is a promising biomimetic agent in oral care formulations that is used in different products such as toothpastes, mouthwashes, and gels. 10,11 HAP has an excellent biocompatibility and, in contrast to fluorides, does not lead to dental fluorosis, that is, it is ideally suited for all age groups including infants and young children. 12 Its application, in any reasonable dose, does not pose any risks for a patient's health.…”

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“…6,9,29 In situ studies show an efficient reduction of bacterial colonization to enamel surfaces by using HAP-based mouth rinses. 18,23,30 This might be also an important factor for tooth whitening since stains are often incorporated into dental plaque. 1 In contrast to the HAP-gel, the tested mouth rinse showed only minor whitening effects in our in vitro setting after one, three, and nine cycles.…”

“…1,[5][6][7][8][9] In particular, biomimetic HAP is inspired by structure and composition of natural enamel crystallites 10 and shows a broad range of applications in preventive oral health care, [11][12][13][14][15][16][17] such as antibiofilm properties. 18 A recently published Eur J Dent:2020;14:335-341…”