Role of bioglass in enamel remineralization: Existing strategies and future prospects—A narrative review

Abstract

Enamel, once formed, loses the ability to regenerate due to the loss of the formative ameloblasts. It is subjected to constant damaging events due to exposure to external agents and oral microbiomes. An enamel remineralization process targets to replenish the lost ionic component of the enamel through a multitude of methods. Enamel remineralization is highly challenging as it has a complex organized hierarchical microstructure. Hydroxyapatite nanocrystals of the enamel vary in size and orientation along alignment planes inside the enamel rod. The inability of the enamel to remodel unlike other mineralized tissues is another substantial deterrent. One of the wellknown biomaterials, bioglass (BG) induces apatite formation on the external surface of the enamel in the presence of saliva or other physiological fluids. Calcium, sodium, phosphate, and silicate ions in BG become responsive in the presence of body fluids, leading to the precipitation of calcium phosphate. Studies have also demonstrated the bactericidal potential of BG against Streptococcus mutans biofilms. The anticariogenicity and antibacterial activity were found to be enhanced when BG was doped with inorganic ions such as F, Ag, Mg, Sr, and Zn. Due to the versatility of BG, it has been combined with a variety of agents such as chitosan, triclosan, and amelogenin to biomimic remineralization process. Key strategies that can aid in the development of contemporary enamel remineralization agents are also included in this review.

Efficacy of ClinproTMXT Varnish surrounding brackets on the enamel surface of white spot lesion.

“…The focal point of these ionic exchanges is based on the epitaxial deposition of calcium and phosphate ions on existing apatite crystallites. Many materials, including fluoride varnishes such as Duraphat, glass ionomer-based materials, Regenerate, infiltrating resins and MI paste promote enamel remineralization 16 , 17 , 18 , 19 , 20 . These materials release calcium and fluoride ions that promote the obliteration of pores 16 and regularization of the enamel surface.…”

In vivo evaluation of electrophoresis-aided re-mineralization on surface topography and chemical composition of de-mineralized enamel: an in vivo animal model study

“…Surface charge is predicted to have a significant impact on inorganic and organic deposition processes as well as on structural evolution [41]. Ionic flux from the glass matrix and crystallization have been significantly impacted by changes in the BAG component with cation addition [42].…”

Synchrotron X-ray Studies of the Structural and Functional Hierarchies in Mineralised Human Dental Enamel: A State-of-the-Art Review

“…Such a task would require the aim being rebuilding enamel with a similar texture and high resistance to acid, and offering remineralisation pathways from the surface to the depth of cavities. For additional details, readers are referred to specific reviews on remineralisation [ 197 , 199 , 200 , 201 , 202 , 203 , 204 , 205 , 206 , 207 , 208 , 209 , 210 , 211 , 212 , 213 , 214 , 215 ] and studies of the various types of materials used for enamel repair, including ceramics [ 216 ], polymers [ 217 ], bioinspired composites [ 218 ], bioinspired nanocrystals [ 219 ], bioglass [ 202 ], and coating with calcium phosphate ion clusters [ 220 ].…”