Caries is one of the most common diseases in dentistry. The key to preventing caries is
the balance between demineralization and remineralization. Dental delivery methods such as toothpaste, gels, and varnishes are commonly applied as preventative methods against caries. With the advancement of nano-technology, dentistry can supplement traditional diagnostic and treatment methods with more advanced, efficient, and personalized dental care. Hydroxyapatite (HA) is a biomimetic agent that aims to remineralize and protect the enamel from erosion. It is formed by nanoparticles similar to apatite crystals of tooth enamel. Furthermore, it is one of the most biocompatible and bioactive materials. Because HA is present in our enamel, it will be proven as an effective biomimetic agent for the prevention and remineralization of caries.
The Caries Management by Risk Assessment (CAMBRA) tool helps dental care professionals identify high-risk patients more susceptible to caries. With the addition of biomimetic agents such as hydroxyapatite, dentists can effectively provide treatment to detect early-stage lesions and correctly intervene with remineralization techniques in all patient types.
Studies have shown that HA toothpastes have anti-bacterial properties against S. mutans caries causing bacteria, and inhibit demineralization, similar to fluoride. In orthodontic patients, no significant difference was found between fluoride and HA dentifrice on caries progression nor between HA and fluoride gel in remineralizing initial caries. Similar reports found non-inferiority of hydroxyapatite toothpaste compared to fluoride toothpaste.
Fluoride's mechanism of action differs from HA in that hydroxyapatite protects enamel by creating a new layer of enamel, and fluoride hardens the existing enamel layer. A comparison of three biomimetic agents, Casein Phosphopeptides Amorphous Calcium Phosphate (CPP-ACP), Tricalcium Phosphate (TCP), and hydroxyapatite found hydroxyapatite to have the highest amount of remineralization with nHA being more effective in managing early caries and decreasing lesion depth. Hydroxyapatite toothpaste was also shown to be a favorable alternative to oxidizing bleaching agents and zinc-carbonate hydroxyapatite being more effective than a fluoride/potassium nitrate dentifrice in reducing dentin hypersensitivity. With the high consumption of acidic food and beverages, a Zinc-nHA toothpaste was to be more effective than fluoride toothpaste in remineralization and protection after the acid attack and demineralization from Coca-Cola.
In conclusion, with the reported results of the studies in this paper, it is known that nano- hydroxyapatite is an effective and safe alternative to fluoride. Many studies have proven nano-hydroxyapatite effective in helping to remineralize early carious lesions. In some studies, it is just as promising as fluoride is. It is especially beneficial for high-risk patients to implement nHA into their oral care routine. Nano-hydroxyapatite (nHA) has been proven to promote remineralization, inhibit demineralization, whiten teeth, protect against dental erosion, and reduce dentin hypersensitivity.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/46315 |
| Date | 09 June 2023 |
| Creators | Rehman, Malieka |
| Contributors | Davies, Theresa A. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | Attribution-NoDerivatives 4.0 International, http://creativecommons.org/licenses/by-nd/4.0/ |
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