Biomimetic remineralization of dentin

Abstract

Objectives Remineralization of demineralized dentin is important for improving dentin bonding stability and controlling primary and secondary caries. Nevertheless, conventional dentin remineralization strategy is not suitable for remineralizing completely-demineralized dentin within hybrid layers created by etch-and-rinse and moderately aggressive self-etch adhesive systems, or the superficial part of a caries-affected dentin lesion left behind after minimally invasive caries removal. Biomimetic remineralization represents a different approach to this problem by attempting to backfill the demineralized dentin collagen with liquid-like amorphous calcium phosphate nanoprecursor particles that are stabilized by biomimetic analogs of noncollagenous proteins. Methods This paper reviewed the changing concepts in calcium phosphate mineralization of fibrillar collagen, including the recently discovered, non-classical particle-based crystallization concept, formation of polymer-induced liquid- precursors (PILP), experimental collagen models for mineralization, and the need for using phosphate-containing biomimetic analogs for biomimetic mineralization of collagen. Published work on the remineralization of resin-dentin bonds and artificial caries-like lesions by various research groups was then reviewed. Finally, the problems and progress associated with the translation of a scientifically-sound concept into a clinically-applicable approach are discussed. Results and Significance The particle-based biomimetic remineralization strategy based on the PILP process demonstrates great potential in remineralizing faulty hybrid layers or caries-like dentin. Based on this concept, research in the development of more clinically feasible dentin remineralization strategy, such as incorporating poly(anionic) acid-stabilized amorphous calcium phosphate nanoprecursor-containing mesoporous silica nanofillers in dentin adhesives, may provide a promising strategy for increasing of the durability of resin-dentin bonding and remineralizing caries-affected dentin.

Zinc-modified nanopolymers improve the quality of resin–dentin bonded interfaces

“…those parts of the bonded interface at which mineralization is taking place) [26]. Mineralization is found in all groups at the bottom of the hybrid layer, were adhesive resin is not infiltrated (Figure 3), Masson's trichrome staining results did also confirm this fact (Figure 4), it has been previously shown that zones within the hybrid layer that were well-infiltrated by adhesive resin did not undergo remineralization [27].…”

Calcium orthophosphates (CaPO 4 ): Occurrence and properties

“…Thus, according to the current knowledge, the enamel self-repairing ability by a passive remineralization appears to be doubtful, while an active remineralization is impossible. Nevertheless, investigations in this field keep going (Karlinsey and Mackey 2009;Karlinsey et al 2010a, b;Busch 2004;Onuma et al 2005;He and Feng 2007;Li et al 2008bLi et al , 2014aWang et al 2009;Roveri et al 2009a, b;Peters et al 2010;Orsini et al 2010;Uysal et al 2010;Niu et al 2014). For example, ACPcontaining orthodontic biocomposite resins might reduce the enamel decalcification found in patients with poor oral hygiene (Uysal et al 2010).…”

Secondary caries and microleakage

“…Efforts to achieve biomimetic remineralization in dentin are ongoing [47], with a major rationale that once the dentin begins to remineralize its biomechanical properties improve [48]. However, the remineralisation of these zones in the dentin is far more complex than in enamel, since there are no seed mineral crystals that remain like in enamel [49].…”