Efficacy of amelogenin-chitosan hydrogel in biomimetic repair of human enamel in pH-cycling systems

Abstract

Amelogenin-chitosan (CS-AMEL) hydrogel has shown great potential for the prevention, restoration, and treatment of defective enamel. As a step prior to clinical trials, this study aimed to examine the efficacy of CS-AMEL hydrogel in biomimetic repair of human enamel with erosive or caries-like lesions in pH-cycling systems. Two models for enamel defects, erosion and early caries, were addressed in this study. Two pH-cycling systems were designed to simulate the daily cariogenic challenge as well as the nocturnal pH conditions in the oral cavity. After pH cycling and treatment with CS-AMEL hydrogel, a synthetic layer composed of oriented apatite crystals was formed on the eroded enamel surface. CS-AMEL repaired the artificial incipient caries by re-growing oriented crystals and reducing the depth of the lesions by up to 70% in the pH-cycling systems. The results clearly demonstrate that the CS-AMEL hydrogel is effective at the restoration of erosive and carious lesions under pH-cycling conditions.

State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management

“…Recently, several promising strategies have been proposed to replicate the complex enamel microstructure using synthetic amelogenin-based systems. Recombinant porcine amelogenin (rP172) was found to stabilize calcium phosphate clusters and promote the growth of hierarchically arranged enamel crystals on acid-etched lesions, significantly improving its hardness and elastic modulus [Fan et al, 2009;Ruan et al, 2013Ruan et al, , 2016. This biomimetic regrowth of HA crystals also generated a robust interface between the newly formed layer and native enamel ensuring efficacy and durability of restorations.…”

In-vitro subsurface remineralisation of artificial enamel white spot lesions pre-treated with chitosan

“…Recently, chitosan has been used to remineralise enamel lesions. Chitosan-amelogenin (CS-AMEL) hydrogel was shown to induce in-vitro biomimetic remineralisation on either etched enamel or artificial enamel lesions [29] [30] [31]. Enamel-like crystals formed, and lesion depth decreased.…”

Anti-biofilm and remineralization effects of chitosan hydrogel containing amelogenin-derived peptide on initial caries lesions

“…The CS-QP5 hydrogel was prepared using the protocol developed by Ruan et al [ 34 ] with some modifications. In total 1 ml of a chitosan calcium phosphate solution (960 µl of 1% chitosan, 25 µl of 0.1 M CaCl 2 and 15 µl of 0.1 M Na 2 HPO 4 ) was mixed with QP5 to obtain the final concentration of 25 µM, followed by stirring overnight at room temperature.…”