Modulated regeneration of acid-etched human tooth enamel by a functionalized dendrimer that is an analog of amelogenin

Advancing dentin remineralization: Exploring amorphous calcium phosphate and its stabilizers in biomimetic approaches

OBJECTIVE

This review elucidates the mechanisms underpinning intrafibrillar mineralization, examines various amorphous calcium phosphate (ACP) stabilizers employed in dentin's intrafibrillar mineralization, and addresses the challenges encountered in clinical applications of ACP-based bioactive materials.

METHODS

The literature search for this review was conducted using three electronic databases: PubMed, Web of Science, and Google Scholar, with specific keywords. Articles were selected based on inclusion and exclusion criteria, allowing for a detailed examination and summary of current research on dentin remineralization facilitated by ACP under the influence of various types of stabilizers.

RESULTS

This review underscores the latest advancements in the role of ACP in promoting dentin remineralization, particularly intrafibrillar mineralization, under the regulation of various stabilizers. These stabilizers predominantly comprise non-collagenous proteins, their analogs, and polymers. Despite the diversity of stabilizers, the mechanisms they employ to enhance intrafibrillar remineralization are found to be interrelated, indicating multiple driving forces behind this process. However, challenges remain in effectively designing clinically viable products using stabilized ACP and maximizing intrafibrillar mineralization with limited materials in practical applications.

SIGNIFICANCE

The role of ACP in remineralization has gained significant attention in dental research, with substantial progress made in the study of dentin biomimetic mineralization. Given ACP's instability without additives, the presence of ACP stabilizers is crucial for achieving in vitro intrafibrillar mineralization. However, there is a lack of comprehensive and exhaustive reviews on ACP bioactive materials under the regulation of stabilizers. A detailed summary of these stabilizers is also instrumental in better understanding the complex process of intrafibrillar mineralization. Compared to traditional remineralization methods, bioactive materials capable of regulating ACP stability and controlling release demonstrate immense potential in enhancing clinical treatment standards.

Application of a calcium and phosphorus biomineralization strategy in tooth repair: a systematic review

Biomineralization is a natural process in which organisms regulate the growth of inorganic minerals to form biominerals with unique layered structures, such as bones and teeth, primarily composed of calcium and phosphorus. Tooth decay significantly impacts our daily lives, and the key to tooth regeneration lies in restoring teeth through biomimetic approaches, utilizing mineralization strategies or materials that mimic natural processes. This review delves into the types, properties, and transformations of calcium and phosphorus minerals, followed by an exploration of the mechanisms behind physiological and pathological mineralization in living organisms. It summarizes the mechanisms and commonalities of biomineralization and discusses the advancements in dental biomineralization research, guided by insights into calcium and phosphorus mineral biomineralization. This review concludes by addressing the current challenges and future directions in the field of dental biomimetic mineralization.

Self-assembled branched polypeptides as amelogenin mimics for enamel repair

The regeneration of demineralized enamel holds great significance in the treatment of dental caries. Amelogenin (Ame), an essential protein for mediating natural enamel growth, is no longer secreted after enamel has fully matured in childhood. Although biomimetic mineralization based on peptides or proteins has made significant progress, easily accessible, low-cost, biocompatible and highly effective Ame mimics are still lacking. Herein, we construct a series of amphiphilic branched polypeptides (CAMPs) by facile coupling of the Ame's C-terminal segment and poly(γ-benzyl-L-glutamate), which serves to simulate the Ame's hydrophobic N-terminal segment. Among them, CAMP15 is the best biomimetic mineralization template with great self-assembly performance to guide the oriented crystallization of hydroxyapatite and is capable of inhibiting the adhesion of Streptococcus mutans and Staphylococcus aureus on the enamel surfaces. This work highlights the potential application of amphiphilic branched polypeptide as Ame mimics in repairing defected enamel, providing a promising strategy for prevention and treatment of dental caries.

Combined Effect of a Bioinspired Self-Assembling Peptide and Fluoride Varnish on Remineralisation of Artificial Early Enamel Caries Lesion: An in vitro Study

INTRODUCTION

This study aimed to investigate the remineralisation effect of combined use of a bioinspired self-assembling peptide (P26) and fluoride varnish on artificial early enamel caries lesions.

METHODS

Bovine enamel blocks with artificial early enamel caries lesions were prepared. The blocks were randomly allocated to four experimental groups to receive the following treatments: A = P26 + fluoride varnish, B = P26, C = fluoride varnish, and D. distilled water (negative control). The treated blocks were subjected to pH cycling. Enamel blocks were collected at time points of 7 days (d7) and 21 days (d21). The mineral gain, elemental analysis and crystal characteristics of the caries lesion were assessed by micro-computed tomography, scanning electron microscopy with energy dispersive X-ray and X-ray diffraction (XRD), respectively.

RESULTS

The mean ± standard deviation of mineral gain of group A to D were 17.4 ± 4.2%, 10.7 ± 2.2%, 10.1 ± 1.2%, and 6.8 ± 0.5% at d7, respectively, and 15.2 ± 2.6%, 8.7 ± 3.1%, 9.7 ± 1.2%, and 7.8 ± 2.3% at d21, respectively. A significant higher mineral gain was observed in group A when compared to other groups at both d7 and d21 (p < 0.05). The calcium-to-phosphate ratio remained consistent across all groups, ranging between 1.2 and 1.4. XRD analysis indicated that crystal composition on the surfaces was apatite for all groups.

CONCLUSION

In conclusion, the present study provided a first indication of better remineralisation effects of the combined use of the bioinspired self-assembling peptide P26 and fluoride varnish compared to the effects of the respective individual uses of P26 or fluoride varnish.

Bioinspired Multiscale Mineralization: From Fundamentals to Potential Applications

The wondrous and imaginative designs of nature have always been an inexhaustible treasure trove for material scientists. Throughout the long evolutionary process, biominerals with hierarchical structures possess some specific advantages such as outstanding mechanical properties, biological functions, and sensing performances, the formation of which (biomineralization) is delicately regulated by organic component. Provoked by the subtle structures and profound principles of nature, bioinspired functional minerals can be designed with the participation of organic molecules. Because of the designable morphology and functions, multiscale mineralization has attracted more and more attention in the areas of medicine, chemistry, biology, and material science. This review provides a summary of current advancements in this extending topic. The mechanisms underlying mineralization is first concisely elucidated. Next, several types of minerals are categorized according to their structural characteristic, as well as the different potential applications of these materials. At last, a comprehensive overview of future developments for bioinspired multiscale mineralization is given. Concentrating on the mechanism of fabrication and broad application prospects of multiscale mineralization, the hope is to provide inspirations for the design of other functional materials.

Unveiling the mechanism of an amelogenin-derived peptide in promoting enamel biomimetic remineralization

Amelogenin and its derived peptides have exhibited excellent efficacy in promoting enamel biomimetic remineralization. However, little is known about their specific action mechanisms. Herein, by combining experiments and computer simulation, the mechanism of an amelogenin-derived peptide QP5 in regulating enamel biomimetic remineralization is unveiled for the first time. In experiments, peptide QP5 was separated into (QPX)5 and C-tail domains, the interactions of peptide-minerals in nucleation solution and the regulation of peptide on enamel biomimetic remineralization were explored. QP5 exhibited an unordered conformation when mineral ions existed, and it could adsorb on minerals through its two domains, thereby inhibiting spontaneous nucleation. The remineralized enamel regulated by C-tail showed better mechanical properties and formed more biomimetic crystals than that of (QPX)5, indicating the C-tail domain of QP5 played an important role in forming enamel-like crystals. The simulation results showed that the conformation of QP5 changed greatly, mainly exhibiting β-bend, β-turn, and coil structures, and it eventually adsorbed on enamel through negatively charged residues of the C-tail domain, then captured Ca2+ from solution to promote enamel remineralization. This study improved the evaluation methods of the mechanism of biomimetic peptides, and laid a theoretical basis for the amelioration and clinical transformation of peptide QP5.

Cementum is key to periodontal tissue regeneration: A review on apatite microstructures for creation of novel cementum-based dental implants

The cementum is the outermost layer of hard tissue covering the dentin within the root portion of the teeth. It is the only hard tissue with a specialized structure and function that forms a part of both the teeth and periodontal tissue. As such, cementum is believed to be critical for periodontal tissue regeneration. In this review, we discuss the function and histological structure of the cementum to promote crystal engineering with a biochemical approach in cementum regenerative medicine. We review the microstructure of enamel and bone while discussing the mechanism underlying apatite crystal formation to infer the morphology of cementum apatite crystals and their complex structure with collagen fibers. Finally, the limitations of the current dental implant treatments in clinical practice are explored from the perspective of periodontal tissue regeneration. We anticipate the possibility of advancing periodontal tissue regenerative medicine via cementum regeneration using a combination of material science and biochemical methods.

Novel bioactive dental restorations to inhibit secondary caries in enamel and dentin under oral biofilms

OBJECTIVE

To provide the first review on cutting-edge research on the development of new bioactive restorations to inhibit secondary caries in enamel and dentin under biofilms. State-of-the-art bioactive and therapeutic materials design, structure-property relationships, performance and efficacies in oral biofilm models.

DATA, SOURCES AND STUDY SELECTION

Researches on development and assessment new secondary caries inhibition restorations via in vitro and in vivo biofilm-based secondary caries models were included. The search of articles was carried out in Web of Science, PubMed, Medline and Scopus.

CONCLUSIONS

Based on the found articles, novel bioactive materials are divided into different categories according to their remineralization and antibacterial biofunctions. In vitro and in vivo biofilm-based secondary caries models are effective way of evaluating the materials efficacies. However, new intelligent and pH-responsive materials were still urgent need. And the materials evaluation should be performed via more clinical relevant biofilm-based secondary caries models.

CLINICAL SIGNIFICANCE

Secondary caries is a primary reason for dental restoration failures. Biofilms produce acids, causing demineralization and secondary caries. To inhibit dental caries and improve the health and quality of life for millions of people, it is necessary to summarize the present state of technologies and new advances in dental biomaterials for preventing secondary caries and protecting tooth structures against oral biofilm attacks. In addition, suggestions for future studies are provided.

Dendritic Polymers in Tissue Engineering: Contributions of PAMAM, PPI PEG and PEI to Injury Restoration and Bioactive Scaffold Evolution

The capability of radially polymerized bio-dendrimers and hyperbranched polymers for medical applications is well established. Perhaps the most important implementations are those that involve interactions with the regenerative mechanisms of cells. In general, they are non-toxic or exhibit very low toxicity. Thus, they allow unhindered and, in many cases, faster cell proliferation, a property that renders them ideal materials for tissue engineering scaffolds. Their resemblance to proteins permits the synthesis of derivatives that mimic collagen and elastin or are capable of biomimetic hydroxy apatite production. Due to their distinctive architecture (core, internal branches, terminal groups), dendritic polymers may play many roles. The internal cavities may host cell differentiation genes and antimicrobial protection drugs. Suitable terminal groups may modify the surface chemistry of cells and modulate the external membrane charge promoting cell adhesion and tissue assembly. They may also induce polymer cross-linking for healing implementation in the eyes, skin, and internal organ wounds. The review highlights all the different categories of hard and soft tissues that may be remediated with their contribution. The reader will also be exposed to the incorporation of methods for establishment of biomaterials, functionalization strategies, and the synthetic paths for organizing assemblies from biocompatible building blocks and natural metabolites.

Proline-rich protein from S. mutans can perform a competitive mineralization function to enhance bacterial adhesion to teeth

A proline-rich region was found in Streptococcus mutans (S. mutans) surface antigen I/II (Ag I/II). The functions of this region were explored to determine its role in the cariogenic abilities of S. mutans; specifically, the proline-rich region was compared with human amelogenin. The full-length amelogenin genes were cloned from human (AmH) and surface antigen I/II genes from S. mutans. Then, the genes expressed and purified. We analyzed the structure and self-assembly ability of AmH and Ag I/II, compared their capacities to induce mineralization, and assessed the adhesion ability of S. mutans to AmH- and Ag I/II-coated tooth slices. AmH formed ordered chains and net frames in the early stage of protein self-assembly, while Ag I/II formed irregular and overlapping structures. AmH induced mineralization possessed a parallel rosary structure, while Ag I/II-induced mineralization is rougher and more irregular. The S. mutans adhesion assay indicated that the adhesion ability S. mutans on the Ag I/II-induced crystal layer was significantly higher than that on the AmH-induced crystal layer. S. mutans' Ag I/II may have evolved to resemble human amelogenin and form a rougher crystal layer on teeth, which play a competitive mineralization role and promotes better bacterial adhesion and colonization. Thus, the cariogenic ability of S. mutans Ag I/II is increased.

A Dentin Biomimetic Remineralization Material with an Ability to Stabilize Collagen

The integrity of collagen matrix structure is a prerequisite for effectively inducing biomimetic remineralization. Repeated low pH stimulation activates matrix metalloproteinases (MMPs) in dental caries. Activated MMPs cause the breakdown of collagen fibrils. Collagen stabilization is a major obstacle to the clinical application of remineralization templates. Here, galardin-loaded poly(amido amine) (PAMAM)-NGV (PAMAM-NGV@galardin, PNG) is constructed to induce collagen stabilization and dentin biomimetic remineralization simultaneously, in order to combat early caries in dentin. PAMAM acts in the role of nucleation template for dentin remineralization, while galardin acts as the role of MMPs inhibitor. NGV peptides modified on the surface of dendrimer core can form small clusters with synergistic movement in short range, and those short-range clusters can form domain areas with different properties on the surface of PAMAM core and restrict the movement of collagen, favoring collagen crosslinking, which can be explained through the computational simulation analysis results. NGV peptides and galardin show a dual collagen-protective effect, laying the foundation for the dentin remineralization effect induced by PAMAM. PNG induces dentin remineralization in an environment with collagenase, meanwhile showsing anti-dentin caries efficacy in vivo. These findings indicate that PNG has great potential to combat early dentin caries for future clinical application.

Application of Amorphous Calcium Phosphate Agents in the Prevention and Treatment of Enamel Demineralization

Enamel demineralization, as a type of frequently-occurring dental problem that affects both the health and aesthetics of patients, is a concern for both dental professionals and patients. The main chemical composition of the enamel, hydroxyapatite, is easy to be dissolved under acid attack, resulting in the occurrence of enamel demineralization. Among agents for the preventing or treatment of enamel demineralization, amorphous calcium phosphate (ACP) has gradually become a focus of research. Based on the nonclassical crystallization theory, ACP can induce the formation of enamel-like hydroxyapatite and thereby achieve enamel remineralization. However, ACP has poor stability and tends to turn into hydroxyapatite in an aqueous solution resulting in the loss of remineralization ability. Therefore, ACP needs to be stabilized in an amorphous state before application. Herein, ACP stabilizers, including amelogenin and its analogs, casein phosphopeptides, polymers like chitosan derivatives, carboxymethylated PAMAM and polyelectrolytes, together with their mechanisms for stabilizing ACP are briefly reviewed. Scientific evidence supporting the remineralization ability of these ACP agents are introduced. Limitations of existing research and further prospects of ACP agents for clinical translation are also discussed.

Novel trends, challenges and new perspectives for enamel repair and regeneration to treat dental defects

Dental enamel is the hardest tissue in the human body, providing external protection for the tooth against masticatory forces, temperature changes and chemical stimuli. Once enamel is damaged/altered by genetic defects, dental caries, trauma, and/or dental wear, it cannot repair itself due to the loss of enamel producing cells following the tooth eruption. The current restorative dental materials are unable to replicate physico-mechanical, esthetic features and crystal structures of the native enamel. Thus, development of alternative approaches to repair and regenerate enamel defects is much needed but remains challenging due to the structural and functional complexities involved. This review paper summarizes the clinical aspects to be taken into consideration for the development of optimal therapeutic approaches to tackle dental enamel defects. It also provides a comprehensive overview of the emerging acellular and cellular approaches proposed for enamel remineralization and regeneration. Acellular approaches aim to artificially synthesize or re-mineralize enamel, whereas cell-based strategies aim to mimic the natural process of enamel development given that epithelial cells can be stimulated to produce enamel postnatally during the adult life. The key issues and current challenges are also discussed here, along with new perspectives for future research to advance the field of regenerative dentistry.

Remineralization of human dentin type I collagen fibrils induced by carboxylated polyamidoamine dendrimer/amorphous calcium phosphate nanocomposite: an in vitro study

Intrafibrillar mineralization of type I collagen fibrils is of great significance in dental remineralization, which is the key of caries prevention and treatment. Herein, two substances that have the remineralization ability, carboxylated polyamidoamine dendrimer (PAMAM-COOH) and nano-sized amorphous calcium phosphate (n-ACP) were combined to synthesize a novel nanomaterial, carboxylated polyamidoamine dendrimer/amorphous calcium phosphate nanocomposite (PAMAM-COOH/ACP). This article aims to evaluate the remineralization effect of PAMAM-COOH/ACP of dentin type I collagen fibrils in vitro. Fluorescence labeling technique was innovatively used to observe and evaluate the remineralization effect. PAMAM-COOH/ACP showed superior remineralization ability of human dentin type I collagen fibrils, especially the intrafibrillar remineralization. Therefore, the novel nanomaterial PAMAM-COOH/ACP is promising to prevent and treat various diseases caused by dentin demineralization and to improve various dental materials.

Polyzwitterion Manipulates Remineralization and Antibiofilm Functions against Dental Demineralization

Biomineralization technology has become a trend for the arrest and prevention of dental caries. In particular, the bioactivity and ability to release large amounts of Ca²⁺ and PO₄^3- ions make amorphous calcium phosphate (ACP) for hard tissue remineralization are highly desired. However, the instability of ACP limits its clinical application. Under continuous bacterial challenge in the oral cavity, the currently developed ACP-based remineralization system lacks the ability to inhibit bacterial adhesion and biofilm formation. Here, a dual-functional nanocomposite with antibiofilm and remineralization properties was designed by combining zwitterionic poly(carboxybetaine acrylamide) (PCBAA) and ACP. The resulting nanocomposite was stable in solution for at least 3 days without any aggregation. The PCBAA/ACP nanocomposite exerted a significant inhibitory effect on the adhesion and biofilm formation of Streptococcus mutans and exhibited bactericidal activities under acidic conditions resulting from bacteria. Moreover, compared with fluoride, this nanocomposite demonstrated superior effects in promoting the remineralization of demineralized enamel and the occlusion of exposed dentinal tubules in vivo and in vitro. The present work provides a theoretical and experimental basis for the use of the PCBAA/ACP nanocomposite as a potential dual-functional agent for arresting and preventing caries.

Advances in biomineralization-inspired materials for hard tissue repair

Biomineralization is the process by which organisms form mineralized tissues with hierarchical structures and excellent properties, including the bones and teeth in vertebrates. The underlying mechanisms and pathways of biomineralization provide inspiration for designing and constructing materials to repair hard tissues. In particular, the formation processes of minerals can be partly replicated by utilizing bioinspired artificial materials to mimic the functions of biomolecules or stabilize intermediate mineral phases involved in biomineralization. Here, we review recent advances in biomineralization-inspired materials developed for hard tissue repair. Biomineralization-inspired materials are categorized into different types based on their specific applications, which include bone repair, dentin remineralization, and enamel remineralization. Finally, the advantages and limitations of these materials are summarized, and several perspectives on future directions are discussed.

Advanced non-fluoride approaches to dental enamel remineralization: The next level in enamel repair management

In modern dentistry, a minimally invasive management of early caries lesions or early-stage erosive tooth wear (ETW) with synthetic remineralization systems has become indispensable. In addition to fluoride, which is still the non-plus-ultra in these early caries/ETW treatments, a number of new developments are in the test phase or have already been commercialized. Some of these systems claim that they are comparable or even superior to fluoride in terms of their ability to remineralize enamel. Besides, their use can help avoid some of the risks associated with fluoride and support treatments of patients with a high risk of caries. Two individual non-fluoride systems can be distinguished; intrinsic and extrinsic remineralization approaches. Intrinsic (protein/peptide) systems adsorb to hydroxyapatite crystals/organics located within enamel prisms and accumulate endogenous calcium and phosphate ions from saliva, which ultimately leads to the re-growth of enamel crystals. Extrinsic remineralization systems function on the basis of the external (non-saliva) supply of calcium and phosphate to the crystals to be re-grown. This article, following an introduction into enamel (re)mineralization and fluoride-assisted remineralization, discusses the requirements for non-fluoride remineralization systems, particularly their mechanisms and challenges, and summarizes the findings that underpin the most promising advances in enamel remineralization therapy.

Phosphorylated PAMAM dendrimers: an analog of dentin non-collagenous proteins, enhancing the osteo/odontogenic differentiation of dental pulp stem cells

OBJECTIVES

Polyamidoamine (PAMAM) dendrimers have well-defined structures, with monodispersity and easily modified surface groups, and they have broad applications in biomedicine. In this study, phosphorylated PAMAM (P-PAMAM) dendrimers were synthesized based on the idea of mimicking the phosphorylated proteins of dentin non-collagenous proteins (DNCP). Then, proliferation and osteo/odontogenic differentiation effects of P-PAMAM on dental pulp stem cells (DPSCs) were investigated and were compared with DNCP.

MATERIALS AND METHODS

P-PAMAM was synthesized via the Mannich-type reaction. DNCP were extracted directly from human dentin with ethylenediaminetetraacetic acid (EDTA) solution. Then, the conditioned medium of P-PAMAM and DNCP were prepared respectively and applied to DPSCs. Proliferation of P-PAMAM was investigated with CCK-8, flow cytometry, and EdU test. Osteo/odontogenic differentiation of P-PAMAM was analyzed using alkaline phosphatase activity and staining, RT-PCR, western blot, alizarin red staining, and immunofluorescence staining.

RESULTS

Fourier transform infrared spectroscopy and ¹H nuclear magnetic resonance revealed that PAMAM were successfully phosphorylated. Western blot verified that the extracted DNCP contained dentin-related proteins DSPP, OPN, and BMP2. In cell proliferation, there was no apparent difference between P-PAMAM, DNCP, and Control groups (P > 0.05). P-PAMAM and DNCP upregulated related genes and proteins expression (DSPP/DSPP, COL-1/COL-1, ALP/ALP, RUNX2/RUNX2, OSX/OSX, OCN/OCN) and matrix mineralization. Still, the potential was lower than that of DNCP (P < 0.05).

CONCLUSIONS

P-PAMAM dendrimers, as a biomimetic analog of DNCP, promote osteo/odontogenic differentiation of DPSCs without influencing their proliferation at a low concentration.

CLINICAL RELEVANCE

This preliminary study about P-PAMAM dendrimers is expected to provide a more convenient bioactive macromolecular material for the regeneration of the pulp-dentin complex.

A novel anticaries agent, honokiol-loaded poly(amido amine) dendrimer, for simultaneous long-term antibacterial treatment and remineralization of demineralized enamel

OBJECTIVE

Existing agents to induce enamel self-repair and inhibit the progression of dental caries in the early stage have been proven to be inadequate and far from satisfactory. In this study, a honokiol-loaded poly(amido amine) (PAMAM) dendrimer (PAMH) was constructed to combat early caries lesions in enamel.

METHODS

PAMH was prepared via a codissolution method. Computational simulation analysis was used to explore the mechanism of honokiol release. The cytotoxicity of PAMH was tested. The antibacterial effects of PAMH were tested by planktonic growth assays and biofilm formation inhibition assays. The remineralization effect of PAMH was examined via transverse microradiography and scanning electron microscopy after a pH cycling model. The in vivo anti-caries effect of PAMH was carried out in a rat model.

RESULTS

Honokiol released from PAMH was slower but more durable in a cariogenic pH environment than in a neutral pH environment, which could be explained through the computational simulation analysis results. Under electrostatic action, P3 beads with the same charge repelled each other and extended outwards, resulting in the rapid expansion of the PAMAM dendrimer and accelerating the release of the drug. At a low pH of 5.5, the protonated P3 beads were not charged and the protonated P1 beads were positively charged. However, the electrostatic repulsive interaction between protonated P1 beads was restricted by the P3 beads in the outermost layer of the PAMAM dendrimer, so the swelling rate was relatively slow, resulting in the slow release of drug molecules in the acidic environment. The cytotoxicity demonstration and the biocompatibility experiment in animal study showed that PAMH is biologically safe. PAMH showed excellent enamel remineralizing ability after pH cycling and showed a long-term antibacterial effect in vitro. Meanwhile, PAMH showed long-term anticaries efficacy in vivo.

SIGNIFICANCE

Our findings indicated that PAMH had great potential to combat early caries lesions in enamel for future clinical application.

Enamel-like tissue regeneration by using biomimetic enamel matrix proteins

Enamel regeneration currently -is limited by our inability to duplicate artificially its complicated and well-aligned hydroxyapatite structure. The initial formation of enamel occurs in enamel organs where the ameloblasts secret enamel extracellular matrix formed a unique gel-like microenvironment. The enamel extracellular matrix is mainly composed by amelogenin and non-amelogenin. In this study, an innovative strategy was proposed to regenerate enamel-like tissue by constructing a microenvironment using biomimetic enamel matrix proteins (biomimetic EMPs) composed of modified leucine-rich amelogenin peptide (mLRAP) and non-amelogenin analog (NAA). Impressively, the regenerated enamel in this biomimetic EMPs on etched enamel surface produced prismatic structures, and showed similar mechanical properties to natural enamel. The results of X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) showed that regenerated crystal was hydroxyapatite. Molecular dynamics simulation analysis showed the binding energy between mLRAP and NAA were electrostatic forces and Van der Walls. These results introduced a promising strategy to induce crystal growth of enamel-like hydroxyapatite for biomimetic reproduction of materials with complicated hierarchical microstructures.

Effect of Protein-Based Treatment on Chemical Composition, Hardness and Bond Strength of Remineralized Enamel

This study evaluated the chemical composition and microhardness of human enamel treated with an Enamel Matrix Derivative (EMD) solution, and the bond strength between composite resin and this enamel. Thirty human enamel samples were randomly divided into three groups: Untouched Enamel (UE), Demineralized Enamel (DE) and Demineralized Enamel Treated with EMD (ET). DE and ET groups were subjected to acid challenge and ET treated with EMD (EMD was directly applied over conditioned enamel and left for 15 min). Samples from each group (n=4) had chemical composition assessed through to attenuated total reflectance Fourier transform infrared (ATR-FTIR). Knoop microhardness of enamel samples from each group (n=10) was measured. For the microshear bond strength, the samples were etched for 30 s, and the adhesive was applied and cured for 10 s. Two matrixes were placed on the samples, filled with Filtek Z350 XT composite and cured for 20 s, each. The matrix was removed, and the microshear bond strength of each group (n=10) was tested. Data were subjected to Kruskal-Wallis test (for microhardness), to analysis of variance and to Tukey's test (for microshear bond strength); (α=0.05). FTIR results have shown phosphate (hydroxyapatite indicator) in 900-1200 cm-1 bands in the UE and ET groups, which were different from the DE group. Microhardness and microshear analyses recorded higher statistical values for the UE and ET groups than for DE. EMD application to demineralized enamel seems to have remineralized the enamel; thus, the microhardness and bond strength was similar between UE and ET groups.

[Application of biomimetic restoration in oral-maxillofacial hard tissue repair]

Oral-maxillofacial hard tissue is the support of maxillofacial structure and appearance, and lays the foundation for functions of oral and maxillofacial system. Once the defect occurs, it will not only affect the physiological functions such as chewing and pronunciation, but also have a significant impact on the psychological and social life of patients. However, the self-repairing capability of the oral-maxillofacial hard tissue is pretty limited, in which case, substitute materials are required for tissue repair. A huge gap exists between the physical, chemical, structural characteristics of conventional substitute materials and those of human hard tissues, resulting in poor repair effect. Based on this, scholars simulated the process of biomineralization in the development of hard tissues, to improve the structure and function of materials through biomimetic mineralization technology and enhance the repair performance of materials. The current understanding of biomineralization theory and the construction of biomimetic repair technology is still in the stage of rapid development. In recent years, a mass of innovative studies are keeping emerging. In this review, the representative advances in the repair of oral-maxillofacial hard tissues of the past five years are reviewed.

Remineralization of dentin induced by a compound of polyamide-amine and chlorhexidine in a resin dentin bonding microenvironment

Background

The purpose of this study was to investigate the effect of a complex of polyamide-amine dendrimer (PAMAM) and chlorhexidine gluconate (CG) on remineralization of dentin in an artificial simulated resin dentin bonding microenvironment.

Methods

The structure of this complex was characterized by FT-IR. Twelve standard dentin samples were randomly divided into four treatment fluid groups namely a PAMAM group, CG group, PAMAM + CG group, and deionized water group. A microenvironmental mineralization model was established in vitro with 50 µm gap width between resin and dentin. The dentin surface was observed by a scanning electron microscope (SEM), and the chemical structure of the surface was analyzed by X-ray energy spectrum (EDS), X-ray diffraction (XRD), and laser Raman spectroscopy.

Results

SEM showed the density of dentinal tubules exposed in the PAMAM group decreased after a 14-day immersion, with corn rod-shaped crystal structures gathered around the tubules. In addition, visible mineralization occurred in partial areas of the CG group, rod-shaped crystals and in comparison, dentinal tubules in the PAMAM + CG group were almost completely covered by flaky crystal structures. Raman spectrum analysis showed that crystals formed by PAMAM, CG, and PAMAM + CG solution all had strong phosphate characteristic peaks, indicating the presence of hydroxyapatite (HA), that of the PAMAM + CG group was the strongest. The EDS results showed that the Ca and P levels of the PAMAM group and the CG group were slightly higher than those of the deionized water group, while PAMAM + CG group significantly higher than the others, Ca/P value approaching 1.67. The results of XRD showed the characteristic peaks of hydroxyapatite detected by the PAMAM + CG group at 2θ=26.0 (002), 2θ=32.0 (211), and 2θ=33.0 (112) were high and sharp, with a few diffraction line burrs indicating it had high crystallinity and purity. The Scherrer equation results showed that the appearance and size of the grains formed by the PAMAM + CG group were basically consistent with those of healthy dentin.

Conclusions

Altogether, the compound of polyamide-amine dendrimer and chlorhexidine could induce the remineralization of human dentin in a resin dentin bonding microenvironment with a gap of 50 µm to form a crystal structure similar to dentin hydroxyapatite.

Remineralization of dentine tubules induced by phosphate-terminated PAMAM dendrimers

Various sealants have been developed to treat the exposure of dentinal tubules (DTs) and further dental hypersensitivity. Herein, the phosphate-terminated fourth generation polyamidoamine dendrimers (PAMAM-PO₃H₂) was successfully synthesized. Six duplicates of demineralized dentin and type I collagen matrix were incubated in artificial saliva solution with or without PAMAM-PO₃H₂ treatment at 37 °C for 2 weeks, respectively. The artificial saliva solution was replaced every day. These regenerated crystals on the surface of dentin and collagen matrix were confirmed to be hydroxyapatite (HAp). The approach thus demonstrates that PAMAM-PO₃H₂ can offer an efficient therapy for seal DTs in clinical dentistry.

Two-in-one strategy: a remineralizing and anti-adhesive coating against demineralized enamel

Tooth enamel is prone to be attacked by injurious factors, leading to a de/remineralization imbalance. To repair demineralized enamel and prevent pulp inflammation caused by biofilm accumulation, measures are needed to promote remineralization and inhibit bacterial adhesion on the tooth surface. An innovative material, poly (aspartic acid)-polyethylene glycol (PASP-PEG), was designed and synthesized to construct a mineralizing and anti-adhesive surface that could be applied to repair demineralized enamel. A cytotoxicity assay revealed the low cytotoxicity of synthesized PASP-PEG. Adsorption results demonstrated that PASP-PEG possesses a high binding affinity to the hydroxyapatite (HA)/tooth surface. In vitro experiments and scanning electron microscopy (SEM) demonstrated a strong capacity of PASP-PEG to induce in situ remineralization and direct the oriented growth of apatite nanocrystals. Energy dispersive X-ray spectroscopy (EDS), X-ray diffraction analysis (XRD) and Vickers hardness tests demonstrated that minerals induced by PASP-PEG were consistent with healthy enamel in Ca/P ratio, crystal form and surface micro-hardness. Contact angle tests and bacterial adhesion experiments demonstrated that PASP-PEG yielded a strong anti-adhesive effect. In summary, PASP-PEG could achieve dual effects for enamel repair and anti-adhesion of bacteria, thereby widening its application in enamel repair.

Challenges of Engineering Biomimetic Dental and Paradental Tissues

BACKGROUND

Loss of the dental and paradental tissues resulting from trauma, caries or from systemic diseases considered as one of the most significant and frequent clinical problem to the healthcare professionals. Great attempts have been implemented to recreate functionally, healthy dental and paradental tissues in order to substitute dead and diseased tissues resulting from secondary trauma of car accidents, congenital malformations of cleft lip and palate or due to acquired diseases such as cancer and periodontal involvements.

METHOD

An extensive literature search has been done on PubMed database from 2010 to 2019 about the challenges of engineering a biomimetic tooth (BioTooth) regarding basic biology of the tooth and its supporting structures, strategies, and different techniques of obtaining biological substitutes for dental tissue engineering.

RESULTS

It has been found that great challenges need to be considered before engineering biomimetic individual parts of the tooth such as enamel, dentin-pulp complex and periodontium. In addition, two approaches have been adopted to engineer a BioTooth. The first one was to engineer a BioTooth as an individual unit and the other was to engineer a BioTooth with its supporting structures.

CONCLUSION

Engineering of BioTooth with its supporting structures thought to be in the future will replace the traditional and conventional treatment modalities in the field of dentistry. To accomplish this goal, different cell lines and growth factors with a variety of scaffolds at the nano-scale level are now in use. Recent researches in this area of interest are dedicated for this objective, both in vivo and in vitro. Despite progress in this field, there are still many challenges ahead and need to be overcome, many of which related to the basic tooth biology and its supporting structures and some others related to the sophisticated techniques isolating cells, fabricating the needed scaffolds and obtaining the signaling molecules.

Rapid regeneration of enamel-like-oriented inorganic crystals by using rotary evaporation

Enamel, the hardest tissue in the human body, has excellent mechanical properties, mainly due to its highly ordered spatial structure. Fabricating enamel-like structure is still a challenge today. In this work, a simple and highly efficient method was introduced, using the silk fibroin as a template to regulate calcium- and phosphate- supersaturated solution to regenerate enamel-like hydroxyapatite crystals on various substrates (enamel, dentin, titanium, and polyethylene) under rotary evaporation. The enamel-like zinc oxide nanorod array structure was also successfully synthesized using the aforementioned method. This strategy provides a new approach to design and fabricate mineral crystals with particular orientation coatings for materials.

Natural protein bioinspired materials for regeneration of hard tissues

This review describes the protein bioinspired materials for the repair of hard tissues such as enamel, dentin and bone.

The potential of dendrimer in delivery of therapeutics for dentistry

Dendrimers are hyperbranched nanoparticle structures along with its surface modifications can to be used in dental biomaterials for biomimetic remineralisation of enamel and dentin. The review highlights the therapeutic applications of dendrimers in the field of dentistry. It addresses the possible mechanisms of enhancement of mechanical properties of adhesives and resins structure. Dendrimers due to its unique construction of possessing inner hydrophobic and outer hydrophilic structure can act as drug carrier for delivery of antimicrobial drugs for treatment of periodontal diseases and at peripheral dental implant areas. Dendrimers due to its hyperbranched structures can provides a unique drug delivery vehicle for delivery of a drug at specific site for sustained release for therapeutic effects. Thus, dendrimers can be one of the most important constituents which can be incorporated in dental biomaterials for better outcomes in dentistry.

Dental remineralization via poly(amido amine) and restorative materials containing calcium phosphate nanoparticles

Tooth decay is prevalent, and secondary caries causes restoration failures, both of which are related to demineralization. There is an urgent need to develop new therapeutic materials with remineralization functions. This article represents the first review on the cutting edge research of poly(amido amine) (PAMAM) in combination with nanoparticles of amorphous calcium phosphate (NACP). PAMAM was excellent nucleation template, and could absorb calcium (Ca) and phosphate (P) ions via its functional groups to activate remineralization. NACP composite and adhesive showed acid-neutralization and Ca and P ion release capabilities. PAMAM+NACP together showed synergistic effects and produced triple benefits: excellent nucleation templates, superior acid-neutralization, and ions release. Therefore, the PAMAM+NACP strategy possessed much greater remineralization capacity than using PAMAM or NACP alone. PAMAM+NACP achieved dentin remineralization even in an acidic solution without any initial Ca and P ions. Besides, the long-term remineralization capability of PAMAM+NACP was established. After prolonged fluid challenge, the immersed PAMAM with the recharged NACP still induced effective dentin mineral regeneration. Furthermore, the hardness of pre-demineralized dentin was increased back to that of healthy dentin, indicating a complete remineralization. Therefore, the novel PAMAM+NACP approach is promising to provide long-term therapeutic effects including tooth remineralization, hardness increase, and caries-inhibition capabilities.

Enamel biomimetics-fiction or future of dentistry

Tooth enamel is a complex mineralized tissue consisting of long and parallel apatite crystals configured into decussating enamel rods. In recent years, multiple approaches have been introduced to generate or regenerate this highly attractive biomaterial characterized by great mechanical strength paired with relative resilience and tissue compatibility. In the present review, we discuss five pathways toward enamel tissue engineering, (i) enamel synthesis using physico-chemical means, (ii) protein matrix-guided enamel crystal growth, (iii) enamel surface remineralization, (iv) cell-based enamel engineering, and (v) biological enamel regeneration based on de novo induction of tooth morphogenesis. So far, physical synthesis approaches using extreme environmental conditions such as pH, heat and pressure have resulted in the formation of enamel-like crystal assemblies. Biochemical methods relying on enamel proteins as templating matrices have aided the growth of elongated calcium phosphate crystals. To illustrate the validity of this biochemical approach we have successfully grown enamel-like apatite crystals organized into decussating enamel rods using an organic enamel protein matrix. Other studies reviewed here have employed amelogenin-derived peptides or self-assembling dendrimers to re-mineralize mineral-depleted white lesions on tooth surfaces. So far, cell-based enamel tissue engineering has been hampered by the limitations of presently existing ameloblast cell lines. Going forward, these limitations may be overcome by new cell culture technologies. Finally, whole-tooth regeneration through reactivation of the signaling pathways triggered during natural enamel development represents a biological avenue toward faithful enamel regeneration. In the present review we have summarized the state of the art in enamel tissue engineering and provided novel insights into future opportunities to regenerate this arguably most fascinating of all dental tissues.

Enamel biomimetics-fiction or future of dentistry

Tooth enamel is a complex mineralized tissue consisting of long and parallel apatite crystals configured into decussating enamel rods. In recent years, multiple approaches have been introduced to generate or regenerate this highly attractive biomaterial characterized by great mechanical strength paired with relative resilience and tissue compatibility. In the present review, we discuss five pathways toward enamel tissue engineering, (i) enamel synthesis using physico-chemical means, (ii) protein matrix-guided enamel crystal growth, (iii) enamel surface remineralization, (iv) cell-based enamel engineering, and (v) biological enamel regeneration based on de novo induction of tooth morphogenesis. So far, physical synthesis approaches using extreme environmental conditions such as pH, heat and pressure have resulted in the formation of enamel-like crystal assemblies. Biochemical methods relying on enamel proteins as templating matrices have aided the growth of elongated calcium phosphate crystals. To illustrate the validity of this biochemical approach we have successfully grown enamel-like apatite crystals organized into decussating enamel rods using an organic enamel protein matrix. Other studies reviewed here have employed amelogenin-derived peptides or self-assembling dendrimers to re-mineralize mineral-depleted white lesions on tooth surfaces. So far, cell-based enamel tissue engineering has been hampered by the limitations of presently existing ameloblast cell lines. Going forward, these limitations may be overcome by new cell culture technologies. Finally, whole-tooth regeneration through reactivation of the signaling pathways triggered during natural enamel development represents a biological avenue toward faithful enamel regeneration. In the present review we have summarized the state of the art in enamel tissue engineering and provided novel insights into future opportunities to regenerate this arguably most fascinating of all dental tissues.

Five pathways for tooth enamel engineering hold great promise for developing new technologies, leading to novel biomaterials and biotechnologies to regenerate enamel tissue. Tooth enamel is a unique tissue-specific biomaterial with exceptional structural and mechanical properties. In recent years, many approaches have been adopted to generate or regenerate this complex tissue; Mirali Pandya and Thomas Diekwisch of Texas A&M College of Dentistry, USA conducted a review of the current state and future directions of enamel tissue engineering. In their review, the authors focused on five pathways for enamel tissue engineering: (1) physical synthesis of enamel; (2) biochemical enamel engineering; (3) in situ enamel engineering; (4) cell-based enamel engineering; and (5) whole tooth regeneration. The authors conclude that those five approaches will help identify the biological mechanisms that lead to the generation of tooth enamel.

Computer simulations of the adsorption of an N-terminal peptide of statherin, SN15, and its mutants on hydroxyapatite surfaces

Salt-bridge adsorption of the SN15 peptide and its mutants on the HAP(001) surface.

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

The principles of minimally invasive dentistry clearly dictate the need for clinically effective measures to remineralize early enamel caries lesions. While fluoride-mediated remineralization is the cornerstone of current caries management philosophies, a number of new remineralization strategies have been commercialized or are under development that claim to promote deeper remineralization of lesions, reduce the potential risks associated with high-fluoride oral care products, and facilitate caries control over a lifetime. These non-fluoride remineralizing systems can be broadly categorized into biomimetic enamel regenerative technologies and the approaches that repair caries lesions by enhancing fluoride efficacy. This paper discusses the rationale for non-fluoride remineralization and the mechanism of action, challenges, and evidence behind some of the most promising advances in enamel remineralization therapies.

One-step phosphorylated poly(amide-amine) dendrimer loaded with apigenin for simultaneous remineralization and antibacterial of dentine

Dental caries, starting from demineralization of enamel and dentine, is closely related with acid-producing bacteria in oral cavity, for example, Streptococcus mutans. Remineralization is an efficient way to prevent the disease progression and facilitate the therapy of incipient caries. Therefore, for the purpose of effective dentine repair, remineralization and antibacterial should be combined simultaneously. However, most of the literatures only focus on one single aspect, while combing remineralization and antibacteria for dentine repair in one system is rarely reported. Here in this work, phosphoryl-terminated poly(amide-amine) dendrimers were loaded with apigenin, a water-nonsoluble drug antibacterial agains Streptococcus mutans. The apigenin-loaded dendrimers bind strongly with dentine, which further induce dentine tubules occlusion through mineralization in artificial saliva, and the release of apigenin can prevent further erosion of dentine by bacteria. Meanwhile, the phosphorylated dendrimers are easily prepared by one-step modification of poly(amide-amine) and exhibit good cytocompatibility. This strategy developed here can provide reference for the design of effective anti-caries materials.

Universal and biocompatible hydroxyapatite coating induced by phytic acid-metal complex multilayer

As the basic component of natural bone in the human body, hydroxyapatite is widely used in orthopedic, dental, and bone implants, especially as a surface coating to improve osteoconductivity and osseointeration of materials. Several methods have been used for hydroxyapatite coating, including plasma spraying, laser pulse deposition, and electrophoretic and electrochemical deposition. However, these methods require expensive instruments and involve complex operations. Thus, it is highly desirable to develop a feasible, simple, cheap, and universal method to prepare hydroxyapatite coatings. In this work, we develop a method for hydroxyapatite coating on various materials by a phytic acid-metal complex multilayer. The abundant phosphate moieties on phytic acid not only work for chemical modification of a wide range of materials but also for further the formation of hydroxyapatite. The formed crystals improve the biocompatibility and osteogenic ability of MG63 cells. This method is simple, cheap, and novel, and can be utilized in biomedical applications such as orthopedic, dental, and bone implants.

Peptide-Based Bioinspired Approach to Regrowing Multilayered Aprismatic Enamel

The gradual discovery of functional domains in native enamel matrix proteins has enabled the design of smart bioinspired peptides for tooth enamel mimetics and repair. In this study, we expanded upon the concept of biomineralization to design smaller amelogenin-inspired peptides with conserved functional domains for clinical translation. The synthetic peptides displayed a characteristic nanostructured scaffold reminiscent of 'nanospheres' seen in the enamel matrix and effectively controlled apatite nucleation in vitro resulting in the formation of smaller crystallites. Following application of the peptides to sectioned human molar teeth, a robust, oriented, synthetic aprismatic enamel was observed after 7 days of incubation in situ. There was a two-fold increase in the hardness and modulus of the regrown enamel-like apatite layers and an increase in the attachment of the tooth-regrown layer interface compared to control samples. Repeated peptide applications generated multiple enamel-like hydroxyapatite (HAP) layers of limited thickness produced by epitaxial growth in which c-axis oriented nanorods evolved on the surface of native enamel. We conclude that peptide analogues with active domains can effectively regulate the orientation of regenerated HAP layers to influence functional response. Moreover, this enamel biofabrication approach demonstrates the peptide-mediated growth of multiple microscale HAP arrays of organized microarchitecture with potential for enamel repair.

Bioinspired heptapeptides as functionalized mineralization inducers with enhanced hydroxyapatite affinity

The regeneration of mineral crystals under physiological conditions is an efficient way to repair defects in hard tissues. To achieve robust mineralization on surfaces such as the tooth enamel, an inducer requires strong affinity with the substrates and should be able to induce mineralization. Thus far, most studies used a single molecule containing two components to realize the above functions separately, which might be troublesome to synthesize and purify. In this work, inspired by the statherin in the salivary acquired pellicle, we designed a simple peptide sequence, Asp-Asp-Asp-Glu-Glu-Lys-Cys (peptide-7), to accomplish the dual tasks of adsorption and mineralization on enamel surfaces. We speculate the calcium binding ability of the negatively charged carboxylic acid groups in the peptide itself contributes to the dual functions of peptide-7. In vitro and in vivo experiments demonstrated its excellent repair effect on enamel as compared to fluoride. More importantly, due to the strong affinity between peptides and hydroxyapatite, a compact mineralized crystal layer and a strong adhesion between the regenerated minerals and the bottom substrates were observed, similar to the effect induced by fluoride. This work sheds light on the interaction mechanism between peptide-7 and minerals. In addition, since it is safer than fluoride, peptide-7 may have potential applications in the repair of other hard tissues and the functionalization of biomaterials.

In vivo analyses of the effects of polyamidoamine dendrimer on dentin biomineralization and dentinal tubules occlusion

This study evaluated the biomineralization and dentinal tubules occlusion abilities of the carboxyl-terminated polyamidoamine dendrimer (PAMAM-COOH) on human demineralized dentin in vivo at different time points. Demineralization dentin model with and without treated with PAMAM-COOH were sutured to the interior side of the rat's cheeks, that was incubated in the rats' saliva for 2, 4 and 6 weeks respectively. Finally, the newly formed precipitates were characterized by SEM, EDS, XRD and microhardness test. The hydroxyapatite (HA) on the dentin treated with PAMAM-COOH were formed gradually with the time going by, and the regenerated HA has a similar crystal structure with natural dentin, whereas the crystallites did not exist on the control group. The microhardness of PAMAM-COOH-applied specimens had a significantly higher than those without application. These results suggest that the PAMAM-COOH promoted the biomineralization of demineralized dentin and displayed favourable effects on blocking the open dentinal tubules.

Functional calcium phosphate composites in nanomedicine

Calcium phosphate (CaP) materials have many peculiar and intriguing properties. In nature, CaP is found in nanostructured form embedded in a soft proteic matrix as the main mineral component of bones and teeth. The extraordinary stoichiometric flexibility, the different stabilities exhibited by its different forms as a function of pH and the highly dynamic nature of its surface ions, render CaP one of the most versatile materials for nanomedicine. This review summarizes some of the guidelines so far emerged for the synthesis of CaP composites in aqueous media that endow the material with tailored crystallinity, morphology, size, and functional properties. First, we introduce very briefly the areas of application of CaP within the nanomedicine field. Then through some selected examples, we review some synthetic routes where the presence of functional units (small templating molecules like surfactants, or oligomers and polymers) assists the synthesis and at the same time impart the functionality or the responsiveness desired for the end-application of the material. Finally, we illustrate two examples from our laboratory, where CaP is decorated by biologically active polymers or prepared within a thermo- and magneto-responsive hydrogel, respectively.

A Dendritic Amphiphile for Efficient Control of Biomimetic Calcium Phosphate Mineralization

The phase behavior of a dendritic amphiphile containing a Newkome-type dendron as the hydrophilic moiety and a cholesterol unit as the hydrophobic segment is investigated at the air-liquid interface. The amphiphile forms stable monomolecular films at the air-liquid interface on different subphases. Furthermore, the mineralization of calcium phosphate beneath the monolayer at different calcium and phosphate concentrations versus mineralization time shows that at low calcium and phosphate concentrations needles form, whereas flakes and spheres dominate at higher concentrations. Energy-dispersive X-ray spectroscopy, X-ray photoelectron spectroscopy, and electron diffraction confirm the formation of calcium phosphate. High-resolution transmission electron microscopy and electron diffraction confirm the predominant formation of octacalcium phosphate and hydroxyapatite. The data also indicate that the final products form via a complex multistep reaction, including an association step, where nano-needles aggregate into larger flake-like objects.

Biomineralization: From Material Tactics to Biological Strategy

Biomineralization is an important tactic by which biological organisms produce hierarchically structured minerals with marvellous functions. Biomineralization studies typically focus on the mediation function of organic matrices on inorganic minerals, which helps scientists to design and synthesize bioinspired functional materials. However, the presence of inorganic minerals may also alter the native behaviours of organic matrices and even biological organisms. This progress report discusses the latest achievements relating to biomineralization mechanisms, the manufacturing of biomimetic materials and relevant applications in biological and biomedical fields. In particular, biomineralized vaccines and algae with improved thermostability and photosynthesis, respectively, demonstrate that biomineralization is a strategy for organism evolution via the rational design of organism-material complexes. The successful modification of biological systems using materials is based on the regulatory effect of inorganic materials on organic organisms, which is another aspect of biomineralization control. Unlike previous studies, this study integrates materials and biological science to achieve a more comprehensive view of the mechanisms and applications of biomineralization.