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Biomimetic Remineralization on Enamel and Dentin

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A special issue of Biomimetics (ISSN 2313-7673). This special issue belongs to the section "Biomimetics of Materials and Structures".

Deadline for manuscript submissions: closed (1 June 2023) | Viewed by 34742

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Special Issue Editors

Dr. Hamid Nurrohman

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Guest Editor

Missouri School of Dentistry & Oral Health, A.T. Still University, Kirksville, MO, USA
Interests: cariology; operative dentistry; bonding; biomaterials; biomimetic remineralization; enamel; dentin; clinical translation

Dr. Jinhui Tao

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Guest Editor

Physical Sciences Division, Pacific Northwest National Laboratory, Richland, WA 99352, USA
Interests: crystal nucleation and growth for calcium phosphates, calcium carbonates, metals, metal oxides, and metal-organic frameworks (MOFs) under different functional template substrates, additives, and electric fields by in situ AFM, TEM, and FTIR/Raman spectroscopy; development of advanced AFM capabilities such as 3D FFM, EC-AFM, scanning thermal microscopy, and magnetic force microscopy
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Special Issue Information

Dear Colleagues,

The philosophy of dental care toward prevention and minimally invasive restorative approaches by promoting remineralization is a critical element of dental treatments. Achieving oriented and ordered remineralization on the surface of demineralized dental enamel–dentin and restoring the good mechanical properties of the sound tooth is still a challenge for dentists. With the progress in understanding the biomineralization of dental hard tissue, it will become possible to develop a biomimetic remineralization strategy by simulating the biomineralization process. A pure solution-based approach is not feasible for application in clinical dentistry. Therefore, research on the problem and progress associated with translating a scientifically sound concept into a clinically applicable approach is in order.

This Special Issue aims to collect contributions from different laboratories working on biomimetic remineralization. Covering issues from proof-of-concept to (basics) clinical translation, it provides an updated view of the potential strategies that would allow the transfer of the biomimetic remineralization method into the dental clinic. The present collection of papers takes advantage of the open access format and is expected to provide a paradigm of the power of biomimetic approaches for discovering new and important research avenues and innovative solutions in nanotechnology and dentistry.

We believe that this initiative will fill an essential gap in biomimetic remineralization, and the clinical delivery system will stimulate enthusiastic contributions from leading experts in the field.

Dr. Hamid Nurrohman
Dr. Jinhui Tao
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomimetics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

biomimetic
remineralization
enamel
dentin
basics clinical translation

Published Papers (12 papers)

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Research

Jump to: Review

10 pages, 2031 KiB

Open AccessArticle

Evaluation of Resin Infiltration, Fluoride and the Biomimetic Mineralization of CPP-ACP in Protecting Enamel after Orthodontic Inter-Proximal Enamel Reduction

by Naser Almansouri, Ahmed Samir Bakry, Mona Aly Abbassy, Amal Ibrahim Linjawi and Ali Habib Hassan

Biomimetics 2023, 8(1), 82; https://doi.org/10.3390/biomimetics8010082 - 14 Feb 2023

Cited by 3 | Viewed by 1750

Abstract

Background: This study investigated the effect of using different agents for protecting enamel proximal surfaces against acidic attack after interproximal reduction (IPR) using the trans micro radiography technique. Methods: Seventy-five sound-proximal surfaces were obtained from extracted premolars for orthodontic reasons. All teeth were measured miso-distally and mounted before being stripped. The proximal surfaces of all teeth were hand stripped with single-sided diamond strips (OrthoTechnology, West Columbia, SC, USA) followed by polishing via Sof-Lex polishing strips (3M, Maplewood, MN, USA). Three-hundred micrometers of enamel thickness was reduced from each proximal surface. The teeth were randomly divided into 5 groups: group 1 (control un-demineralized) received no treatment, group 2 (control demineralized) had their surfaces demineralized after the IPR procedure, group 3 (fluoride) specimens were treated with fluoride gel (NUPRO, DENTSPLY, Charlotte, NC, USA) after the IPR, group 4 (Icon) resin infiltration material (Icon Proximal Mini Kit, DMG, Bielefeld, Germany) was applied after IPR, group 5 (MI varnish) specimens were treated with Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing varnish (MI Varnish, G.C, USA, St. Alsip, IL, USA) after the IPR. The specimens in (groups 2–5) were stored in a 4.5 pH demineralization solution for 4 days. The trans-micro-radiography (TMR) technique was conducted to evaluate the mineral loss (∆Z) and lesion depth of all specimens after the acid challenge. The obtained results were analyzed statistically using a one-way ANOVA at a significance level of α = 0.05. Results: The MI varnish recorded significant ∆Z and lesion depth values compared to the other groups p > 0.05. There was no significant difference in ∆Z and lesion depth between the control demineralized, Icon, and fluoride groups p < 0.05. Conclusion: The MI varnish increased the enamel resistance to acidic attack, and thus can be considered an agent capable of protecting the proximal enamel surface after IPR. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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13 pages, 2653 KiB

Open AccessArticle

Natural Bioactive Epigallocatechin-Gallate Promote Bond Strength and Differentiation of Odontoblast-like Cells

by Rene Garcia-Contreras, Patricia Alejandra Chavez-Granados, Carlos Alberto Jurado, Benjamin Aranda-Herrera, Kelvin I. Afrashtehfar and Hamid Nurrohman

Biomimetics 2023, 8(1), 75; https://doi.org/10.3390/biomimetics8010075 - 10 Feb 2023

Cited by 4 | Viewed by 2240

Abstract

The (-)-Epigallocatechin-gallate (EGCG) metabolite is a natural polyphenol derived from green tea and is associated with antioxidant, biocompatible, and anti-inflammatory effects. Objective: To evaluate the effects of EGCG to promote the odontoblast-like cells differentiated from human dental pulp stem cells (hDPSCs); the antimicrobial effects on Escherichia coli, Streptococcus mutans, and Staphylococcus aureus; and improve the adhesion on enamel and dentin by shear bond strength (SBS) and the adhesive remnant index (ARI). Material and methods: hDSPCs were isolated from pulp tissue and immunologically characterized. EEGC dose-response viability was calculated by MTT assay. Odontoblast-like cells were differentiated from hDPSCs and tested for mineral deposition activity by alizarin red, Von Kossa, and collagen/vimentin staining. Antimicrobial assays were performed in the microdilution test. Demineralization of enamel and dentin in teeth was performed, and the adhesion was conducted by incorporating EGCG in an adhesive system and testing with SBS-ARI. The data were analyzed with normalized Shapiro–Wilks test and ANOVA post hoc Tukey test. Results: The hDPSCs were positive to CD105, CD90, and vimentin and negative to CD34. EGCG (3.12 µg/mL) accelerated the differentiation of odontoblast-like cells. Streptococcus mutans exhibited the highest susceptibility < Staphylococcus aureus < Escherichia coli. EGCG increased (p < 0.05) the dentin adhesion, and cohesive failure was the most frequent. Conclusion: (-)-Epigallocatechin-gallate is nontoxic, promotes differentiation into odontoblast-like cells, possesses an antibacterial effect, and increases dentin adhesion. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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10 pages, 1630 KiB

Open AccessArticle

Comparative Efficacy of Novel Biomimetic Remineralising Technologies

by Peiyan Shen, James R. Fernando, Yi Yuan, Coralie Reynolds and Eric C. Reynolds

Biomimetics 2023, 8(1), 17; https://doi.org/10.3390/biomimetics8010017 - 02 Jan 2023

Cited by 1 | Viewed by 1818

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. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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10 pages, 657 KiB

Open AccessArticle

Biomimetic Whitening Effect of Polyphosphate-Bleaching Agents on Dental Enamel

by Abdullah Alshehri, Basil Almutairi, Carlos A. Jurado, Kelvin I. Afrashtehfar, Shug Albarrak, Asma Alharbi, Alanoud Alenazi, Hamid Nurrohman and Abdulrahman Alshabib

Biomimetics 2022, 7(4), 183; https://doi.org/10.3390/biomimetics7040183 - 29 Oct 2022

Cited by 2 | Viewed by 2643

Abstract

This in vitro study investigated the extrinsic tooth-whitening effect of bleaching products containing polyphosphates on the dental enamel surface compared to 10% carbamide peroxide (CP). Eighty human molars were randomly allocated into four whitening-products groups. Group A (control) was treated with 10% CP (Opalescence). The other groups with non-CP over-the-counter (OTC) products were group B = polyphosphates (iWhiteWhitening-Kit); group C = polyphosphates+fluoride (iWhite-toothpaste); and group D = sodium bicarbonate (24K-Whitening-Pen). L*, a*, b* color-parameters were spectrophotometer-recorded at baseline (T0), one day (T1), and one month (T2) post-treatment. Changes in teeth color (ΔE_ab) were calculated. Data were analyzed using ANOVA and the Bonferroni test (α = 0.05). Groups A, B, and D showed significant differences in ΔL*&Δa* parameters at T1, but not in Δb* at T0. Group C showed no difference for ΔL*, Δa*, Δb* at T0 and T1. Group A showed differences for ΔL*, Δa*, Δb*, at T2, while groups B, C, and D had no difference in any parameters at T0. At T1, ΔE_ab values = A > D> B > C (ΔE_ab = 13.4 > 2.4 > 2.1 > 1.2). At T2, ΔE_ab values increased = A > B > C > D (ΔE_ab = 12.2 > 10.6 > 9.2 > 2.4). In conclusion, the 10% CP and Biomimetic polyphosphate extrinsic whitening kit demonstrated the highest color change, while simulated brushing with dark stain toothpaste and a whitening pen demonstrated the lowest color change at both measurement intervals. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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11 pages, 925 KiB

Open AccessArticle

Effects of Accelerated Aging on Color Stability and Surface Roughness of a Biomimetic Composite: An In Vitro Study

by Abdullah Alshehri, Feras Alhalabi, Mohammed Mustafa, Mohamed M. Awad, Mohammed Alqhtani, Mohammed Almutairi, Faisal Alhijab, Carlos A. Jurado, Nicholas G. Fischer, Hamid Nurrohman and Abdulrahman Alshabib

Biomimetics 2022, 7(4), 158; https://doi.org/10.3390/biomimetics7040158 - 09 Oct 2022

Cited by 6 | Viewed by 2283

Abstract

The aim of this in vitro study is to compare the color stability and surface roughness of conventional and self-blending resin composites before and after staining and aging. Three conventional composites (Filtek Z350, IPS Empress Direct, and Estalite Palfique LX5) and one self-blending (Omnichroma) resin composite were used in this study. Sixty discs were prepared and polymerized in a metal mold (n = 15 per group). Samples were then finished and polished by Layan discs. Color testing and roughness testing were measured as a baseline (T0) by a spectrophotometer and profilometry. Samples were then stained with tea for 24 h, water aged for 30 days, and then a second reading (T1) was performed. Finishing and polishing were performed again, and a third reading (T2) was collected. All groups showed significant decrease in all color parameters (L*, a*, and b*); however, after polishing, all groups showed color enhancements matching pre-experiment baseline colors in all color parameters (L*, a*, and b*), except for Estelite Palfique LX5, which showed a significant difference in L relative to the baseline. Furthermore, Estalite Palfique LX5 showed increased roughness after staining compared to the baseline, unlike other groups. No significant differences in color stability were found between self-blending composites and other composite materials. Accelerated aging and staining had minimal effects on the surface roughness of self-blending composite. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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Review

Jump to: Research

24 pages, 729 KiB

Open AccessReview

Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence

by Hardy Limeback, Joachim Enax and Frederic Meyer

Biomimetics 2023, 8(4), 331; https://doi.org/10.3390/biomimetics8040331 - 27 Jul 2023

Cited by 3 | Viewed by 3678

Abstract

As the demand for clinically effective fluoride-free oral care products for consumers increases, it is important to document which types of toothpastes have been shown in clinical studies to be effective in improving oral health. In this review, we included different indications, i.e., caries prevention, improving periodontal health, reducing dentin hypersensitivity, protecting against dental erosion, and safely improving tooth whitening in defining what constitutes improvement in oral health. While there are several professional and consumer fluoride-containing formulations fortified with calcium-phosphate-based ingredients, this review focuses on fluoride-free toothpastes containing biomimetic calcium-phosphate-based molecules as the primary active ingredients. Several databases were searched, and only clinical trials in human subjects were included; in vitro and animal studies were excluded. There were 62 oral health clinical trials on biomimetic hydroxyapatite (HAP), 57 on casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), 26 on calcium sodium phosphosilicate (CSPS, or so called Bioglass), and 2 on β-tricalcium phosphate (β-TCP). HAP formulations were tested the most in clinical trials for benefits in preventing caries, dentin hypersensitivity, improving periodontal health, and tooth whitening. Based on the current clinical evidence to date, fluoride-free HAP toothpaste formulations are the most versatile of the calcium phosphate active ingredients in toothpastes for improving oral health. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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13 pages, 3959 KiB

Open AccessReview

Biomimetic Enamel Regeneration Using Self-Assembling Peptide P₁₁-4

by Mohammad Alkilzy, Ghalib Qadri, Christian H. Splieth and Ruth M. Santamaría

Biomimetics 2023, 8(3), 290; https://doi.org/10.3390/biomimetics8030290 - 04 Jul 2023

Cited by 2 | Viewed by 2935

Abstract

The recent understanding of the etiology and pathology of dental caries has shifted its treatment from invasive drill and fill conventional strategies to noninvasive and/or minimally invasive approaches. Guided tissue regeneration (GTR) is a well-established therapeutic approach in medicine and periodontal and oral surgery. Recently, the concept of biomimetic regeneration has been further expanded to treat the loss of hard dental tissues. Self-assembling peptides have emerged as a promising biomaterial for biomimetic regeneration due to their ability to construct a protein scaffold in the body of early carious lesions and provide a matrix that promotes remineralization. This review article accompanies the development of self-assembling peptide P₁₁-4 for the treatment of initial carious lesions. In vitro and in vivo studies on the safety, clinical applicability, and efficacy of P₁₁-4 are discussed. Furthermore, different treatment options and potential areas of application are presented. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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Graphical abstract

15 pages, 3298 KiB

Open AccessReview

Investigation of Surface Layers on Biological and Synthetic Hydroxyapatites Based on Bone Mineralization Process

by Kazuto Sugimoto, Yanni Zhou, Tania Guadalupe Peñaflor Galindo, Reo Kimura and Motohiro Tagaya

Biomimetics 2023, 8(2), 184; https://doi.org/10.3390/biomimetics8020184 - 28 Apr 2023

Cited by 3 | Viewed by 1764

Abstract

In this review, the current status of the influence of added ions (i.e., SiO₄⁴⁻, CO₃²⁻, etc.) and surface states (i.e., hydrated and non-apatite layers) on the biocompatibility nature of hydroxyapatite (HA, Ca₁₀(PO₄)₆(OH)₂) is discussed. It is well known that HA is a type of calcium phosphate with high biocompatibility that is present in biological hard tissues such as bones and enamel. This biomedical material has been extensively studied due to its osteogenic properties. The chemical composition and crystalline structure of HA change depending on the synthetic method and the addition of other ions, thereby affecting the surface properties related to biocompatibility. This review illustrates the structural and surface properties of HA substituted with ions such as silicate, carbonate, and other elemental ions. The importance of the surface characteristics of HA and its components, the hydration layers, and the non-apatite layers for the effective control of biomedical function, as well as their relationship at the interface to improve biocompatibility, has been highlighted. Since the interfacial properties will affect protein adsorption and cell adhesion, the analysis of their properties may provide ideas for effective bone formation and regeneration mechanisms. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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17 pages, 1558 KiB

Open AccessReview

Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-Analysis

by Ali Azhar Dawasaz, Rafi Ahmad Togoo, Zuliani Mahmood, Azlina Ahmad and Kannan Thirumulu Ponnuraj

Biomimetics 2023, 8(2), 159; https://doi.org/10.3390/biomimetics8020159 - 15 Apr 2023

Cited by 2 | Viewed by 2124

Abstract

The objective of this article was to systematically provide an up-to-date review on the different methods of remineralizing human dentine using different biomimetic agents. The authors performed a systematic search within PubMed, Scopus, and Web of Science in addition to the grey literature in Google Scholar^® using MeSH terms. The PICO question was P: human teeth dentinal sections; I: application of biomimetic remineralizing agents; C: other non-biomimetic approaches; O: extent of remineralization and physical properties of remineralized dentine. The initially identified studies were screened for titles and abstracts. Non-English articles, reviews, animal studies, studies involving the resin–dentine interface, and other irrelevant articles were then excluded. The other remaining full-text articles were retrieved. Bibliographies of the remaining articles were searched for relevant studies that could be included. A total of 4741 articles were found, and finally, 39 full-text articles were incorporated in the current systematic review. From these, twenty-six research studies used non-collagenous protein (NCP) analogs to biomineralize dentine, six studies used bioactive materials derived from natural sources, six studies used zinc hydroxyapatite, and one study used amelogenin peptide to induce hydroxyapatite formation on the surface of demineralized dentine. Additive effects of triclosan and epigenin were assessed when combined with commonly available NCPs. Overall, a moderate risk of bias was observed and, hence, the findings of the included studies could be acceptable. A meta-analysis of some similar studies was performed to assess the depth of remineralization and elastic modulus. Despite having high heterogeneity (I² > 90), all the studies showed a significant improvement in biomimetic remineralization efficacy as compared to the control. All the included studies carried out a functional remineralization assessment and found a 90–98% efficacy in the extent of remineralization while the elastic modulus reached 88.78 ± 8.35 GPa, which is close to natural dentine. It is pertinent to note the limitations of these studies that have been carried out in vitro under controlled settings, which lack the effects of a natural oral environment. To conclude, the authors suggest that the biomimetic remineralization of dentine using NCP analogs, bioactive materials, and natural products carries significant potential in treating dentinal lesions; however, more long-term studies are needed to assess their clinical applications in vivo. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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16 pages, 688 KiB

Open AccessReview

Biomimetic Action of Zinc Hydroxyapatite on Remineralization of Enamel and Dentin: A Review

by Andrea Butera, Carolina Maiorani, Simone Gallo, Maurizio Pascadopoli, Martina Quintini, Marco Lelli, Fabrizio Tarterini, Ismaela Foltran and Andrea Scribante

Biomimetics 2023, 8(1), 71; https://doi.org/10.3390/biomimetics8010071 - 08 Feb 2023

Cited by 9 | Viewed by 3450

Abstract

Biomimetic zinc–carbonate hydroxyapatite technology was developed to realize materials that mimic the natural hydroxyapatite of enamel and dentin and possess good activity in terms of affinity to adhere to these biological tissues. The chemical and physical characteristics of this active ingredient allows the hydroxyapatite itself to be particularly similar to dental hydroxyapatite, enhancing the bond between biomimetic hydroxyapatite and dental hydroxyapatite. The aim of this review is to assess the efficacy of this technology in terms of benefits for enamel and dentin and reduction of dental hypersensitivity. Materials and methods: A literature search (Pubmed/MEDLINE and Scopus) of articles from 2003 to 2023 was conducted to analyze studies focused on the use of zinc-hydroxyapatite products. Duplicates were eliminated from the 5065 articles found, leaving 2076 articles. Of these, 30 articles were analyzed based on the use of products with zinc–carbonate hydroxyapatite in these studies. Results: 30 articles were included. Most of the studies showed benefits in terms of remineralization and prevention of enamel demineralization in terms of occlusion of the dentinal tubules and reduction of dentinal hypersensitivity. Conclusion: Oral care products such as toothpaste and mouthwash with biomimetic zinc–carbonate hydroxyapatite were shown to provide benefits according to the aims of this review. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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29 pages, 4825 KiB

Open AccessReview

Clinical Evidence of Biomimetic Hydroxyapatite in Oral Care Products for Reducing Dentin Hypersensitivity: An Updated Systematic Review and Meta-Analysis

by Hardy Limeback, Joachim Enax and Frederic Meyer

Biomimetics 2023, 8(1), 23; https://doi.org/10.3390/biomimetics8010023 - 06 Jan 2023

Cited by 10 | Viewed by 5579

Abstract

Dentin hypersensitivity (DH) is a very common dental problem that can have a negative impact on the quality of life and can lead to invasive dental procedures. Prevention of DH and control of symptoms are highly desirable. Hydroxyapatite (HAP) has been shown in vitro to block dentinal tubules and in vivo to be a safe and effective additive in oral care products that reduce DH clinically. This study’s aim was to conduct a systematic review and meta-analysis of the current evidence that HAP-containing oral care products reduce DH. Databases were searched, and only clinical trials in humans were included; studies conducted in vitro or on animals were not included. Publications in a foreign language were translated and included. We found 44 published clinical trials appropriate for systematic analysis. More than half of the trials had high-quality GRADE scores. HAP significantly reduced dentin hypersensitivity compared to placebo (39.5%; CI 95% [48.93; 30.06]), compared to fluoride (23%; CI 95% [34.18; 11.82]), and with a non-significant tendency compared to other desensitizing agents (10.2%; CI 95% [21.76; −19.26]). In conclusion, the meta-analysis showed that HAP added to oral care products is a more effective agent than fluoride in controlling dentin hypersensitivity and may be superior to other desensitizers. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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15 pages, 2007 KiB

Open AccessReview

Clinical Efficacy of Biomimetic Bioactive Biomaterials for Dental Pulp Capping: A Systematic Review and Meta-Analysis

by Liliana Argueta-Figueroa, Carlos Alberto Jurado, Rafael Torres-Rosas, Mario Alberto Bautista-Hernández, Abdulaziz Alhotan and Hamid Nurrohman

Biomimetics 2022, 7(4), 211; https://doi.org/10.3390/biomimetics7040211 - 22 Nov 2022

Cited by 3 | Viewed by 2720

Abstract

Recently, biomimetic bioactive biomaterials have been introduced to the market for dental pulp capping. This systematic review and meta-analysis aimed to determine any variation between the effect of using TheraCal LC and other bioactive biomaterials for pulp capping is different, as measured by dentin increment and clinical success. The risk of bias was assessed using the Risk of Bias 2 and Newcastle–Ottawa tools for randomized clinical trials and observational studies. A search for relevant articles was performed on five databases. Additionally, the quality of the included studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A summary of individual studies and a meta-analysis were performed. The odds ratio of data from clinical success was combined using a random-effects meta-analysis. The meta-analysis results showed homogeneity between the studies (I² = 0%). They revealed that the clinical success showed no differences between the patients who received TheraCal LC, light-cured calcium silicate-based biomimetic biomaterial, for dental pulp capping or the comparator biomaterials (p > 0.5). However, the certainty of the evidence was low to moderate due to the risk of bias in the included studies. Full article

(This article belongs to the Special Issue Biomimetic Remineralization on Enamel and Dentin)

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