Search Results (111)

The purpose of this in vitro study was to evaluate the remineralization effect of five preventive treatments on bovine enamel after artificial caries challenge. Sixty sound bovine incisors were randomly distributed into six experimental groups (n = 10). Each group received the following daily preventive treatments for two weeks during pH cycling to assess remineralization efficacy: Group 1—no treatment (control), Group 2—CPP-ACPF treatment, Group 3—fluoride-containing bioactive glass treatment (BioMin™F), Group 4—SnF₂ treatment, Group 5—toothpaste containing fluoride and hydroxyapatite (HA), and Group 6—toothpaste containing HA. Surface hardness changes were evaluated using a nanoindentation tester. Scanning electron microscopy was used to observe changes in surface morphology, and the mineral composition of enamel in each group was analyzed using energy-dispersive X-ray spectroscopy (EDS). Groups 2, 3 and 6 exhibited the highest surface hardness values after pH cycling, with no statistically significant differences among them (p > 0.05), whereas groups 4 and 5 presented significantly lower values (p < 0.05). Although all treatments demonstrated significant remineralization potential—resulting in an 18.7–35.2% increase in surface hardness—none of them fully restored the hardness loss caused by demineralization. SEM observations revealed precipitations mainly in groups 2–4 after the treatments. EDS showed a similar elemental composition on enamel across the groups with no differences compared to the control. Additionally, line scans of the Ca and P content from the surface to the deeper layers resulted higher values in the tested groups compared to the control corresponding to the surface hardness values. The tested remineralizing treatments may be useful to limit the demineralizing effect during caries formation. Full article

Background and Objectives: Sjögren’s syndrome (SS) causes destructive salivary gland dysfunction with substantial oral morbidity. To synthesize practical, evidence-based approaches for early recognition, initial oral management, and timely referral to dental care. Materials and Methods: Narrative review of English-language literature from the Web of Science Core Collection and PubMed, prioritizing systematic reviews, randomized trials, and consensus guidelines. Results: Early oral signs include rapid multifocal root and cervical caries, burning sensations, and rising dental treatment needs. Unstimulated whole saliva ≤ 0.1 mL/min supports significant hypofunction and complements the 2016 ACR/EULAR criteria. Preventive care should combine dietary counseling, salivary stimulation, and topical remineralization. Adjuncts include high-fluoride toothpaste, biomimetic hydroxyapatite dentifrices, and casein phosphopeptide–amorphous calcium phosphate (CPP-ACP). However, evidence for fluoride varnish in SS remains mixed. Pharmacologic sialogogues require screening for contraindications. Conclusions: Embedding oral screening, simple salivary metrics, and a structured referral pathway into rheumatology visits can reduce preventable tooth loss and improve comfort, function, and treatment adherence. Full article

This work concerns composite materials containing hydroxyapatite, fluorine, and nanosilver fillers. These composites are intended for the reconstruction of lost hard tooth tissues. The aim of the work was to evaluate the color stability of a flow composite containing hydroxyapatite, fluorine, and silver fillers after artificial thermal, chemical, and a combination of thermal and chemical aging processes. The samples were prepared from a commercial flow-type composite material (Arkona Flow Art, Niemcy, Poland) color A2 VITA (Vita Classical, Vita Zahnfabrick, Bad Sackingen, Germany) original and a modified composite material containing a filler additive of 2 wt.% hydroxyapatite powder containing fluorine (calcium fluoride) and nanosilver (n = 15). An Optishade (Style Italiano, Italy) colorimeter was used to measure color against a black background. Samples were submitted to thermal aging (T) using thermocycling equipment; to chemical aging (C) by immersion on artificial saliva at pH7, 37 °C; and to constant agitation or thermal–chemical aging using a combination of the previous two methods. The modified composite showed reduced color differences compared to the original composite. The results also show that thermal aging has a stronger influence on ΔE increase than chemical and combined aging, but only for the modified composite. Cumulative aging processes had an influence below the acceptability threshold for the modified composite. Full article

Objective: This in vitro study quantitatively compared the time-dependent remineralization potential of three professional agents on artificially induced enamel lesions using Scanning Electron Microscopy (SEM) and energy-dispersive X-ray analysis (EDX). Methods: Sixty extracted sound molars were randomly assigned to three groups (number = 20): G_CPP-ACP, treated with casein phosphopeptide–amorphous calcium phosphate; G_Zn-HA, treated with zinc-hydroxyapatite; and G_F-ACP, treated with fluoridated amorphous calcium phosphate. The crown of each tooth was divided into three areas: one represented the control (CTRL, sound enamel), one underwent demineralization (DEMIN, demineralized enamel), and the third one was at first demineralized and then treated with a remineralizing agent, allowing intra-sample comparison. Artificial lesions were produced by immersion in 0.1 M lactic acid (72 h). Groups were subdivided according to remineralization time (7, 14, 21, and 28 days). Samples underwent daily treatment under a pH-cycling regimen. Surface morphology and Ca/P ratios were evaluated by SEM-EDX, and data were statistically analyzed (p < 0.05). Results: All agents promoted a progressive increase in Ca/P ratio over time, confirming a time-dependent remineralization effect. At day 7, G_Zn-HA showed higher Ca/P values, but from day 14 onward, G_F-ACP produced significantly greater mineral gain than the other groups (p < 0.05). By day 21, G_F-ACP reached Ca/P values approaching CTRL, while G_CPP-ACP and G_Zn-HA remained at lower levels, reaching a plateau respectively at 21 and 14 days. SEM observations supported these findings: G_CPP-ACP and G_Zn-HA showed partial surface recovery, whereas G_F-ACP exhibited a compact, homogeneous enamel-like structure at 28 days. Conclusions: All tested agents demonstrated time-dependent remineralization, enhanced with prolonged exposure, suggesting that the time of application represents a key factor for clinical success. Full article

In recent years, apatite-based materials have garnered significant interest, particularly for applications in tissue engineering. Apatite is most commonly employed as a coating for metallic implants, as a component in composite materials, and as scaffolds for bone and dental tissue regeneration. Among its various forms, hydroxyapatite (HAP) is the most widely used, owing to its natural occurrence in human and animal hard tissues. An emerging area of research involves the use of fluoride-substituted apatite, particularly fluorapatite (FAP), which can serve as a direct fluoride source at the implant site, potentially offering several biological and therapeutic advantages. However, substituting HAP with FAP may lead to unforeseen changes in material behavior due to the differing physicochemical properties of these two calcium phosphate phases. This study investigates the effects of replacing hydroxyapatite with fluorapatite in ceramic–polymer composite materials incorporating β-1,3-glucan as a bioactive polymeric binder. The β-1,3-glucan polysaccharide was selected for its proven biocompatibility, biodegradability, and ability to form stable hydrogels that promote cellular interactions. Nitrogen adsorption analysis revealed that FAP/glucan composites had a significantly lower specific surface area (0.5 m²/g) and total pore volume (0.002 cm³/g) compared to HAP/glucan composites (14.15 m²/g and 0.03 cm³/g, respectively), indicating enhanced ceramic–polymer interactions in fluoride-containing systems. Optical profilometry measurements showed statistically significant differences in profile parameters (e.g., Rp: 134 μm for HAP/glucan vs. 352 μm for FAP/glucan), although average roughness (Ra) remained similar (34.1 vs. 27.6 μm, respectively). Microscopic evaluation showed that FAP/glucan composites had smaller particle sizes (1 μm) than their HAP counterparts (2 μm), despite larger primary crystal sizes in FAP, as confirmed by TEM. XRD analysis indicated structural differences between the apatites, with FAP exhibiting a reduced unit cell volume (524.6 ų) compared to HAP (528.2 ų), due to substitution of hydroxyl groups with fluoride ions. Spectroscopic analyses (FTIR, Raman, ³¹P NMR) confirmed chemical shifts associated with fluorine incorporation and revealed distinct ceramic–polymer interfacial behaviors, including an upfield shift of PO₄³⁻ bands (964 cm⁻¹ in FAP vs. 961 cm⁻¹ in HAP) and OH vibration shifts (3537 cm⁻¹ in FAP vs. 3573 cm⁻¹ in HAP). The glucan polymer showed different hydrogen bonding patterns when combined with FAP versus HAP, as evidenced by shifts in polymer-specific bands at 888 cm⁻¹ and 1157 cm⁻¹, demonstrating that fluoride substitution significantly influences ceramic–polymer interactions in these bioactive composite systems. Full article

Background/Objectives: Recent advancements in biomaterials aimed at closely mimicking natural biological tissues hold great promise for hard tissue regeneration and controlled drug release due to their superior physical, chemical, and biological properties. This study aimed to develop multi-ion doped calcium hydroxyapatite (HAp) scaffolds with chitosan-based coatings for localized drug delivery, incorporating a novel hydrazone compound with potential anticancer activity. Methods: HAp powders doped with magnesium (Mg²⁺), strontium (Sr²⁺), and varying fluoride (F⁻) contents (0–2 mol.%) were synthesized via a hydrothermal method. Scaffolds were fabricated using the sponge replica technique and subsequently coated with chitosan or a chitosan–hydrazone blend. Dopant incorporation was confirmed by electron dispersive X-ray spectroscopy (EDS). Phase composition and morphology were analyzed via X-ray diffraction (XRD) and scanning electron microscopy (SEM). Mechanical properties, bioactivity, cytotoxicity, and hydrazone release profiles were systematically evaluated. Results: EDS confirmed successful incorporation of Mg²⁺ and Sr²⁺ in all powders, while F⁻ was detected only in powders with 1 and 2 mol.% fluoride. XRD and SEM revealed the phase composition and scaffold microstructure. Chitosan coatings significantly improved scaffold compressive strength and reduced degradation rate, indicating enhanced stability in biological environments. The coated scaffolds supported MRC-5 fibroblast viability. The hydrazone compound exhibited dose-dependent antitumor cytotoxicity comparable to cisplatin and showed sustained release from scaffolds for up to 15 days. Conclusions: The combination of multi-ion doped HAp scaffolds and chitosan–hydrazone coatings provides a promising platform for bone tissue engineering and localized cancer therapy, demonstrating both mechanical stability and controlled, sustained drug release. Full article

Background: Dental caries remains one of the most prevalent chronic diseases worldwide. Fluoride has long been recognized as a cornerstone of caries prevention through enamel remineralization, inhibition of demineralization, and antibacterial activity. However, controversies persist regarding systemic exposure, potential health risks, and ethical debates over community water fluoridation. Previous reviews often focused on isolated interventions, whereas a critical synthesis of mechanisms, clinical efficacy, safety, and public health perspectives is still lacking. Methods: This narrative review synthesized peer-reviewed publications from 2000 to 2025 retrieved from PubMed, Scopus, Web of Science, and leading dental journals. Emphasis was placed on randomized controlled trials, systematic reviews, meta-analyses, and major policy documents. Evidence was thematically appraised across mechanisms of action, clinical applications, comparative efficacy, safety, and sociocultural considerations. Results: Fluoride consistently shows preventive and therapeutic benefits across multiple delivery forms, including toothpaste, varnishes, mouthrinses, supplements, and silver diamine fluoride, with particular advantages for high-risk groups such as children, orthodontic patients, and older adults. Nonetheless, study heterogeneity, variations in protocols, and concerns regarding fluorosis and possible neurodevelopmental effects highlight persistent uncertainties. Comparative analyses reveal trade-offs between efficacy and acceptance, for example, the high caries-arrest rate of silver diamine fluoride compared with its esthetic drawback. Emerging alternatives such as nano-hydroxyapatite, fluoride-containing bioactive glass, and probiotic-based approaches are promising but currently supported by limited clinical data. Conclusions: Fluoride remains central to caries prevention, yet its optimal use requires balancing benefits against risks, addressing cultural and socioeconomic barriers, and tailoring strategies to individual and community contexts. This narrative synthesis underscores the need for well-designed multicenter randomized controlled trials, longitudinal studies to refine safe exposure thresholds, evaluations of novel biomaterials and delivery systems, and the incorporation of patient-reported outcomes to guide future evidence-based policies and clinical practices. Full article

Although caries is declining in industrialized countries, early childhood caries and molar–incisor hypomineralization (MIH) remain clinically relevant. To meet the demand for effective and well-tolerated preventive strategies, hydroxyapatite (HAp) has gained attention as a biocompatible, fluoride-free agent. A structured narrative review was conducted to evaluate recent clinical evidence on the use of HAp. A PubMed search identified clinical trials from the past five years that investigated HAp-based products. Studies were included if they reported clinical outcomes related to remineralization, caries prevention, or desensitization. Fifteen clinical studies met the inclusion criteria. HAp seems to be a safe and effective alternative to flouride, especially for children or individuals at risk of overexposure. While both agents show similar efficacy in caries prevention, HAp may offer additional advantages in managing hypersensitivity and MIH. Compared to other remineralizing agents, such as calcium sodium phosphosilicate, HAp demonstrated comparable efficacy. Combination therapies show the most promising results. Future research should explore synergies of active ingredients and include standardized long-term studies to substantiate the clinical relevance of HAp. Full article

This study evaluated the physicochemical and morphological properties of tooth enamel in patients with caries-predisposing SNPs (rs4694075 in AMBN and rs2337359 in TUFT1 genes), based on the DMFT index. We included 40 of 120 individuals (aged 19–43), collecting stimulated saliva and 58 healthy teeth extracted for orthodontic/surgical reasons. Saliva DNA was genotyped. Enamel properties were assessed using Vickers microhardness, deposition thickness, and calcium content. Genotype and allele frequencies aligned with the literature. The TUFT1C/C genotype subgroup showed a significantly higher DMFT index (p = 0.03) compared to the T/T genotype, while AMBN showed no such correlation. Calcium content, microhardness, and enamel thickness were similar across all polymorphic variants of both genes. A statistically significant correlation (p = 0.003) was found between reduced enamel calcium content and a higher DMFT index. Despite existing literature on the subject, the studied SNPs did not reflect any correlation with morphological or physicochemical changes in enamel. The above results suggest that genetic variability identifies patients classified by dentists as being at higher risk of caries, even though these patients follow a non-cariogenic diet and adhere to a hygiene regime. As no structural or physicochemical changes in the enamel of this group were observed, the potential cause may be disturbances in the remineralisation mechanisms or enamel surface properties that promote biofilm adhesion in polymorphic patients. Intensive tooth calcification control algorithms using LIF and RVG, as well as remineralisation cycles to increase hydroxyapatite saturation with calcium phosphates and bioadhesive fluoride delivery systems for long-term biofilm control, are used to more effectively prevent or slow down the progression of caries. Full article

Glass ionomer cements (GICs) are bioactive restorative materials valued for their sustained ion release and remineralisation capacity. However, their long-term interactions with sound enamel and dentine remain underexplored. This 12-month in vitro study aimed to evaluate microstructural and compositional changes in sound dental tissues adjacent to four GICs—Ketac Universal, Fuji IX and Equia Forte Fil (conventional GICs) and the advanced Glass Carbomer (incorporating hydroxyapatite nanoparticles)—using field-emission scanning electron microscopy (FE-SEM) and energy-dispersive X-ray spectroscopy (EDS). Glass Carbomer uniquely formed hydroxyapatite nanoparticles and mineralised regions indicative of active biomineralisation—features not observed with conventional GICs. It also demonstrated greater fluoride uptake into dentine and higher silicon incorporation in both enamel and dentine. Conventional GICs exhibited filler particle dissolution and mineral deposition within the matrix over time; among them, Equia Forte released the most fluoride while Fuji IX released the most strontium. Notably, ion uptake was consistently higher in dentine than in enamel for all materials. These findings indicate that Glass Carbomer possesses superior bioactivity and mineralising potential which may contribute to the reinforcement of sound dental tissues and the prevention of demineralisation. However, further in vivo studies are required to confirm these effects under physiological conditions. Full article

Background/Objectives: The growing demand for biocompatible and fluoride-free alternatives in oral care has led to the development of formulations containing nano-hydroxyapatite (nanoHAP). This study aimed to evaluate the antimicrobial, antibiofilm, antioxidant, and anti-inflammatory properties of a novel mouthwash containing nanoHAP, zinc lactate, D-panthenol, licorice extract, and cetylpyridinium chloride, with particular focus on its efficacy against Staphylococcus aureus and its biofilm on various dental materials. Methods: The antimicrobial activities of the mouthwash KWT0000 and control product ELM were assessed via minimal inhibitory concentration (MIC) testing against selected Gram-positive and Gram-negative bacteria and Candida fungi. Antibiofilm activity was evaluated using fluorescence and digital microscopy following 1-h exposure to biofilms of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The efficacy was compared across multiple dental materials, including titanium, zirconia, and PMMA. Antioxidant capacity was determined using the 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) assay, and anti-inflammatory potential via hyaluronidase inhibition. Results: KWT0000 exhibited strong antimicrobial activity against S. aureus and C. albicans (MICs: 0.2–1.6%) and moderate activity against Gram-negative strains. Fluorescence imaging revealed significant biofilm disruption and bacterial death after 1 h. On metallic surfaces, especially polished titanium and zirconia, KWT0000 reduced S. aureus biofilm density considerably. The formulation also demonstrated superior antioxidant (55.33 ± 3.34%) and anti-inflammatory (23.33 ± 3.67%) activity compared to a fluoride-based comparator. Conclusions: The tested nanoHAP-based mouthwash shows promising potential in antimicrobial and antibiofilm oral care, particularly for patients with dental implants. Its multifunctional effects may support not only plaque control but also soft tissue health. Full article

Background: Due to limitations of fluoride (F) treatment as a main caries preventive measure, it is important to consider the use of other dental caries preventive measures to reduce caries prevalence, especially in its early stages. Recently, new remineralizing agents appeared on the market, with their commercial availability in a variety of oral care products. Objectives: The purposes include providing a scoping review that represents caries remineralizing efficacies of only commercially available products and their existing adverse effects (if it is presented) and ensuring that only evidence-based approved products are included. Methods: The following databases were used in searching scientific literature on 28 October 2024: PubMed, PubMed Advanced Search, MeSH database, and PubMed Clinical Queries. The study selection criteria were as follows: for laboratory, in vitro, and/or in situ—remineralization of enamel-scanning electron microscopy, spectroscopy, microhardness test, light microscopy, profilometry, transverse microhardness microradiography, integrated mineral loss, light microscopy, photothermal radiometry; if it was a randomized controlled trial—CONSORT protocol, ICDAS system (to detect dental caries), diagnostic additional devices; antibacterial ability-colony forming units, DNA-based sequencing, scanning electron microscopy, crystal violet staining, and confocal laser scanning microscopy. Results: This review includes 98 papers: 14 of them describing the current status of caries patterns in the world, 60 studies (45 laboratory studies and 15 RCTs), and 24 systematic reviews were analyzed in order to detect whether new remineralizing agents can replace fluoride in further caries prevention. Conclusions: All reviewed new remineralization agents could be used without additives to treat early caries lesions, but the combination with F promotes better remineralization. Only HAP demonstrated its potential to serve as an alternative to fluoride in oral care products. However, further clinical studies are needed to prove its role in the remineralizing process of initial caries lesions. One also needs to ensure that both the clinical trials and in vitro lab studies use the best gold standards to validate any changes in the tooth structure, both remineralization and demineralization. Full article

Titanium and its alloy scaffolds are widely utilized in clinical settings; however, their biologically inert surfaces and inherent mechanical characteristics impede osteogenesis and soft tissue integration, thereby limiting their application. Selective laser melting (SLM) was employed to fabricate scaffolds with matched cortical bone mechanical properties, achieving a composite coating of hydroxyapatite complexed with trace elements of silicon, strontium, and fluoride (mHA), along with type I collagen (Col I) and fibrinogen (Fg), thus activating the scaffold surface. Initially, we utilized the excellent adhesive properties of dopamine to co-deposit mHA and polydopamine (PDA) onto porous Ti-6Al-4V scaffolds, which was followed by immobilization of type I collagen and fibrinogen onto PDA. This bioinorganic/bioprotein composite coating, formed via PDA bonding, exhibits excellent stability. Moreover, in vitro cell experiments demonstrate excellent biocompatibility of the porous Ti-6Al-4V scaffold with composite bioactive coatings on its surface. Preosteoblasts (MC3T3-E1) and human keratinocytes (HaCaT) exhibit enhanced adhesion and proliferation activity, and the osteogenic performance of the scaffold is significantly improved. The PDA-mHA-Col I-Fg composite-coated porous titanium alloy scaffold holds significant promise in enhancing the efficacy of percutaneous bone transplantation and requires further investigation. Full article

White spot lesions (WSLs) are early clinical stages of enamel demineralization, often related to orthodontic treatment or poor oral hygiene. The use of gels such as fluoride for topical application inhibits demineralization and promotes remineralization of dental tissues through various mechanisms. A variety of therapeutic approaches are available; however, recent research indicates that combined treatment strategies may yield superior clinical outcomes compared to monotherapy. The aim of this study was to critically compare the efficacy of combining multiple treatment techniques for WSLs compared to using these techniques alone. A systematic search was conducted in PubMed, Scopus, and Cochrane databases according to PRISMA guidelines. The PICO strategy was used to formulate the research question: Which clinical approaches combined or isolated (C) influence the treatment and prevention effectiveness (O) of white spot lesions (I) in humans (P) in the last ten years (T)? Inclusion criteria focused on clinical studies from the last ten years evaluating the combined use of at least two treatment techniques for WSL, resulting in a total of 8 randomized controlled trials selected from an initial pool of 1185 articles. Our results suggest that combined treatment strategies, including resin infiltration with fluoride varnish and ozone therapy combined with fluoride application, demonstrated enhanced efficacy in lesion masking and remineralization compared to single-treatment approaches. CPP-ACP and hydroxyapatite-based creams improved aesthetics, particularly when used alongside fluoride varnish. Our study concluded that the combination of remineralization agents like fluoride gel, infiltrative resins, and antimicrobial treatments offers superior outcomes on white spot lesion treatment than using these techniques alone. However, long-term clinical studies are needed to standardize treatment protocols and confirm durability. Full article

A spin-coating technique was used to produce new thin films of fluoride-doped hydroxyapatite (HApF) and fluoride-doped hydroxyapatite in a dextran matrix (HApF-Dx) with the potential to be used as nanocoatings for various biomedical implants. The stability of the suspensions used in obtaining the thin films was confirmed by ultrasonic measurements with double-distilled water as a reference. The HApF and HApF-Dx thin films obtained by spin-coating showed diffraction patterns corresponding to hexagonal hydroxyapatite. The X-ray photoelectron spectroscopy studies confirmed the partial substitution of hydroxyl groups (-OH) by fluoride ions. The FTIR studies were conducted in order to highlight the presence of the functional group specific for the HAp in the samples and the influence of the dextran addition on the vibrational characteristics. The surface morphologies of the HApF and HApF-Dx thin films were explored using scanning electron microscopy (SEM), atomic force microscopy (AFM), and metallographic microscopy (MM). The surfaces of the HApF and HApF-Dx thin films were found to be smooth, homogenous, and nanostructured. The biocompatibility assays on HGF-1 cells confirmed that both coatings exhibited good cell viability for all the tested time intervals (24 and 48 h). The findings highlighted the potential of HApF and HApF-Dx coatings for biomedical applications. Additional information about the HGF-1 adherence and development on the surface of the HApF and HApF-Dx coatings was obtained using metallographic microscopy, scanning electron microscopy, and atomic force microscopy techniques. This research demonstrates that the spin-coating method can be successfully used to fabricate HApF and HApF-Dx nanocoatings for potential biomedical applications. Full article