The role of organic proteins on the crack growth resistance of human enamel

Spatiotemporal Characterization of Microstructure Morphology, Mechanical Properties and Bone Remodeling of Rat Tibia Under Uniaxial Compressive Overload Loading

Bone tissue is subjected to increased mechanical stress during high-intensity work. Inadequate bone remodeling reparability can result in the continuous accumulation of microdamage, leading to stress fractures. The aim of this work was to investigate the characteristics and repair mechanisms of tibial microdamage under several degrees of overload. Also, we aimed at better understanding the effects of overload on the multi-scale structure and mechanical properties of bone. Sixty 5-month female rats were divided into three groups with different time points. Micro-CT was used to evaluate the three-dimensional microstructure, and three-point bending, quasi-static fracture toughness and creep mechanical test were carried out to evaluate the mechanical properties. SEM was used to observe the morphological characteristics of fracture surfaces. Section staining was used to count the microdamage parameters and numbers of osteoblasts and osteoclasts. The microarchitectures of cancellous and cortical bones in the three overload groups showed different degrees of damage. Overload led to a messy crystal structure of cortical bone, with slender microcracks mixed in, and a large number of broken fibers of cancellous bone. The properties associated with the elastic plasticity, fracture toughness, and viscoelasticity of cortical bone reduced in three groups, with that corresponding to day 30 presenting the highest damage. The accumulation of microdamage mainly occurred in the first 14 days, that is, the crack density peaked on day 14. Peak-targeted bone remodeling of cortical and cancellous bones occurred mainly between days 14 and 30. The influence of overload mechanical environment on bone quality at different time points was deeply investigated, which is of great significance for the etiology and treatment of stress fractures.

High throughput automated characterization of enamel microstructure using synchrotron tomography and optical flow imaging

The remarkable damage-tolerance of enamel has been attributed to its hierarchical microstructure and the organized bands of decussated rods. A thorough characterization of the microscale rod evolution within the enamel is needed to elucidate this complex structure. While prior efforts in this area have made use of single particle tracking to track a single rod evolution to various degrees of success, such a process can be both computationally and labor intensive, limited to the evolution path of a single rod, and is therefore prone to error from potentially tracking outliers. Particle image velocimetry (PIV) is a well-established algorithm to derive field information from image sequences for processes that are time-dependent, such as fluid flows and structural deformation. In this work, we demonstrate the use of PIV in extracting the full-field microstructural distribution of rods within the enamel. Enamel samples from a wild African lion were analyzed using high-energy synchrotron X-ray micro-tomography. Results from the PIV analysis provide sufficient full-field information to reconstruct the growth of individual rods that can potentially enable rapid analysis of complex microstructures from high resolution synchrotron datasets. Such information can serve as a template for designing damage-tolerant bioinspired structures for advanced manufacturing. STATEMENT OF SIGNIFICANCE: Thorough characterization and analysis of biological microstructures (viz. dental enamel) allows us to understand the basis of their excellent mechanical properties. Prior efforts have successfully replicated these microstructures via single particle tracking, but the process is computationally and labor intensive. In this work, optical flow imaging algorithms were used to extract full-field microstructural distribution of enamel rods from synchrotron X-ray computed tomography datasets, and a field method was used to reconstruct the growth of individual rods. Such high throughput information allows for the rapid production/prototyping and advanced manufacturing of damage-tolerant bioinspired structures for specific engineering applications. Furthermore, the algorithms used herein are freely available and open source to broaden the availability of the proposed workflow to the general scientific community.

The effects of re-irradiation on the chemical and morphological properties of permanent teeth

This study aimed to assess the in vitro effects of re-irradiation on enamel and dentin properties, simulating head and neck cancer radiotherapy retreatment. Forty-five human permanent molars were classified into five groups: non-irradiated; irradiated 60 Gy, and re-irradiated with doses of 30, 40, and 50 Gy. Raman spectroscopy, scanning electron microscopy (SEM), and energy dispersive x-ray spectroscopy (EDS) were employed for analysis. Raman spectroscopy assessed intensity, spectral area, and specific peaks comparatively. Statistical analysis involved Kolmogorov-Smirnov and One-Way ANOVA tests, with Tukey's post-test (significance level set at 5%). Significant changes in irradiated, non-irradiated, and re-irradiated enamel peaks were observed, including phosphate (438 nm), hydroxyapatite (582 nm), phosphate (960 nm), and carbonate (1070 nm) (p < 0.05). Re-irradiation affected the entire tooth (p > 0.05), leading to interprismatic region degradation, enamel prism destruction, and hydroxyapatite crystal damage. Dentin exhibited tubule obliteration, crack formation, and progressive collagen fiber fragmentation. EDX revealed increased oxygen percentage and decreased phosphorus and calcium post-reirradiation. It is concluded that chemical and morphological changes in irradiated permanent teeth were dose-dependent, exacerbated by re-irradiation, causing substantial damage in enamel and dentin.

Characterizing the microstructures of mammalian enamel by synchrotron phase contrast microCT

The enamel of mammalian teeth is a highly mineralized tissue that must endure a lifetime of cyclic contact and is inspiring the development of next-generation engineering materials. Attempts to implement enamel-inspired structures in synthetic materials have had limited success, largely due to the absence of a detailed understanding of its microstructure. The present work used synchrotron phase-contrast microCT imaging to evaluate the three-dimensional microstructure of enamel from four mammals including Lion, Gray Wolf, Snow Leopard, and Black Bear. Quantitative results of image analysis revealed that the decussation pattern of enamel consists of discrete diazone (D) and parazone (P) bands of rods organized with stacking arrangement of D+/P/D-/P in all mammals evaluated; the D+ and D- refer to distinct diazone bands with juxtaposed rod orientations from the reference plane. Furthermore, the rod orientations in the bands can be described in terms of two principal angles, defined here as the pitch and yaw. While the pitch angle increases from the outer enamel to a maximum (up to ≈ 40°) near the dentin enamel junction, minimal spatial variations are observed in yaw across the enamel thickness. There are clear differences in the decussation parameters of enamel across species that are interpreted here with respect to the structural demands placed on their teeth. The rod pitch and band width of enamel are identified as important design parameters and appear to be correlated with the bite force quotient of the four mammals evaluated. STATEMENT OF SIGNIFICANCE: The multi-functionality of tooth enamel requires both hardness and resistance to fracture, properties that are generally mutually exclusive. Ubiquitous to all mammalian teeth, the enamel is expected to have undergone adaptations in microstructure to accommodate the differences in diet, body size and bite force across animals. For the first time, we compare the complex three-dimensional microstructure of enamel from teeth of multiple mammalian species using synchrotron micro-computed tomography. The findings provide new understanding of the "design" of mammalian enamel microstructures, as well as how specific parameters associated with the decussation of rods appear to be engineered to modulate its fracture resistance.

Influence of water and protein content on the creep behavior in dental enamel

The creep behavior of untreated and deproteinized dental enamel in dry and wet state was analyzed by nanoindentation with a spherical tip. Additionally, the influence of the loading rate was investigated. Dry untreated and deproteinized dental enamel only showed minor creep over 100 s and deproteinization did not affect the dry enamel's behavior significantly. With slower loading rates some creep already occurs during the loading period, such that the creep displacement during load hold is less than with faster loading rates. Wet untreated and deproteinized enamel showed significantly more creep compared to the dry samples. The differences between the untreated and deproteinized enamel were only minor but significant, revealing that water affects the creep behavior of biological materials such as enamel significantly. The proposed deformation mechanism of naturally porous enamel under compression is compaction of the HAP crystallites and fluid displacement within material underneath the indented area. STATEMENT OF SIGNIFICANCE: This study investigates the creep behavior of untreated and deproteinized dental enamel in dry and wet conditions. It is shown that while the protein content does not affect enamel's behavior significantly, the wet conditions lead to an increased creep in enamel. The proposed deformation mechanism of naturally porous enamel under compression is compaction of the HAP crystallites and fluid displacement within material underneath the indented area. Based on this observation a simple analytical model has been developed, aiming to deepen our understanding of the deformation behavior of biological materials.

Tooth Diversity Underpins Future Biomimetic Replications

Although the evolution of tooth structure seems highly conserved, remarkable diversity exists among species due to different living environments and survival requirements. Along with the conservation, this diversity of evolution allows for the optimized structures and functions of teeth under various service conditions, providing valuable resources for the rational design of biomimetic materials. In this review, we survey the current knowledge about teeth from representative mammals and aquatic animals, including human teeth, herbivore and carnivore teeth, shark teeth, calcite teeth in sea urchins, magnetite teeth in chitons, and transparent teeth in dragonfish, to name a few. The highlight of tooth diversity in terms of compositions, structures, properties, and functions may stimulate further efforts in the synthesis of tooth-inspired materials with enhanced mechanical performance and broader property sets. The state-of-the-art syntheses of enamel mimetics and their properties are briefly covered. We envision that future development in this field will need to take the advantage of both conservation and diversity of teeth. Our own view on the opportunities and key challenges in this pathway is presented with a focus on the hierarchical and gradient structures, multifunctional design, and precise and scalable synthesis.

Elucidating the role of keratin 75 in enamel using Krt75tm1Der knock-in mouse model

Keratin 75 (K75) was recently discovered in ameloblasts and enamel organic matrix. Carriers of A161T substitution in K75 present with the skin condition Pseudofollicullitis barbae. This mutation is also associated with high prevalence of caries and compromised structural and mechanical properties of enamel. Krt75^tm1Der knock-in mouse (KI) with deletion of Asn159, located two amino acids away from KRT75^A161T, can be a potential model for studying the role of K75 in enamel and the causes of the higher caries susceptibility associated with KRT75^A161T mutation. To test the hypotheses that KI enamel is more susceptible to a simulated acid attack (SAA), and has altered structural and mechanical properties, we conducted in vitro SAA experiments, microCT, and microhardness analyses on 1st molars of one-month-old WT and KI mice. KI and WT hemimandibles were subjected to SAA and contralateral hemimandibles were used as controls. Changes in enamel porosity were assessed by immersion of the hemimandibles in rhodamine, followed by fluorescent microscopy analysis. Fluorescence intensity of KI enamel after SSA was significantly higher than in WT, indicating that KI enamel is more susceptible to acid attack. MicroCT analysis of 1st molars revealed that while enamel volumes were not significantly different, enamel mineral density was significantly lower in KI, suggesting a potential defect of enamel maturation. Microhardness tests revealed that in KI enamel is softer than in WT, and potentially less resilient to damages. These results suggest that the KI enamel can be used as a model to study the role of K75 in enamel.

Role of the Mineral in the Self-Healing of Cracks in Human Enamel

Human enamel is an incredibly resilient biological material, withstanding repeated daily stresses for decades. The mechanisms behind this resilience remain an open question, with recent studies demonstrating a crack-deflection mechanism contributing to enamel toughness and other studies detailing the roles of the organic matrix and remineralization. Here, we focus on the mineral and hypothesize that self-healing of cracks in enamel nanocrystals may be an additional mechanism acting to prevent catastrophic failure. To test this hypothesis, we used a molecular dynamics (MD) approach to compare the fracture behavior of hydroxyapatite (HAP) and calcite, the main minerals in human enamel and sea urchin teeth, respectively. We find that cracks heal under pressures typical of mastication by fusion of crystals in HAP but not in calcite, which is consistent with the resilience of HAP enamel that calcite teeth lack. Scanning transmission electron microscopy (STEM) images of structurally intact ("sound") human enamel show dashed-line nanocracks that resemble and therefore might be the cracks healed by fusion of crystals produced in silico. The fast, self-healing mechanism shown here is common in soft materials and ceramics but has not been observed in single crystalline materials at room temperature. The crack self-healing in sound enamel nanocrystals, therefore, is unique in the human body and unique in materials science, with potential applications in designing bioinspired materials.

3D-Printed Strong Dental Crown with Multi-Scale Ordered Architecture, High-Precision, and Bioactivity

Mimicking the multi-scale highly ordered hydroxyapatite (HAp) nanocrystal structure of the natural tooth enamel remains a great challenge. Herein, a bottom-up step-by-step strategy is developed using extrusion-based 3D printing technology to achieve a high-precision dental crown with multi-scale highly ordered HAp structure. In this study, hybrid resin-based composites (RBCs) with "supergravity +" HAp nanorods can be printed smoothly via direct ink writing (DIW) 3D printing, induced by shear force through a custom-built nozzle with a gradually shrinking channel. The theoretical simulation results of finite element method are consistent with the experimental results. The HAp nanorods are first highly oriented along a programmable printing direction in a single printed fiber, then arranged in a layer by adjusting the printing path, and finally 3D printed into a highly ordered and complex crown structure. The printed samples with criss-crossed layers by interrupting crack propagation exhibit a flexural strength of 134.1 ± 3.9 MPa and a compressive strength of 361.6 ± 8.9 MPa, which are superior to the corresponding values of traditional molding counterparts. The HAp-monodispersed RBCs are successfully used to print strong and bioactive dental crowns with a printing accuracy of 95%. This new approach can help provide customized components for the clinical restoration of teeth.

Review of Cracked Tooth Syndrome: Etiology, Diagnosis, Management, and Prevention

Cracked tooth syndrome refers to a series of symptoms caused by cracked teeth. This article reviews the current literature on cracked tooth syndrome from four aspects, etiology, diagnosis, management, and prevention, to provide readers integrated information about this. The article begins with an introduction to the odontiatrogenic factors and then covers the noniatrogenic factors that induce cracked tooth syndrome. While the former discusses inappropriate root canal therapy and improper restorative procedures, the latter covers the topics such as the developmental and functional status of cracked tooth syndrome. This is then followed by the description of common clinical diagnosis methods, the prospects of new technologies, and summaries of current clinical management methods, including immediate management and direct and indirect restoration. In the final section, preventive methods and their importance are proposed, with the aim of educating the common population.

Mammalian enamel: A universal tissue and diverse source of inspiration

The natural armors and weapons of the animal kingdom are serving as inspiration in the development of next-generation engineering materials. In this pursuit, seldom considered are the variations in properties across taxa that have evolved to meet their unique functional demands. Here, teeth from six different mammalian species were acquired and categorized according to their bite force quotient (BFQ), which accounts for the allometric scaling between bite force and body size. Selected chemical, microstructural, and mechanical properties of the enamel were quantified across the enamel thickness using spectroscopy and indentation techniques. Results showed that the chemical composition of enamel was significantly (P <  0.05) different between the Low and High BFQ groups, whereas the apatite crystallinity was not. The enamel of all animals exhibited a spatial gradient in mechanical properties that was consistent when evaluated using a normalized framework. Although the elastic modulus, hardness and indentation brittleness were significantly lower in the High BFQ group, the fracture resistance of enamel was significantly higher in this group, potentially reflective of bite force requirements related to diet and predation. Enamel rod decussation was present in all teeth, but there were differences in specific microstructural features. Overall, these results highlight that the diversity of tooth enamel across species should be considered in the pursuit of nature-inspired structural materials. STATEMENT OF SIGNIFICANCE: Natural weapons are serving as inspiration in the development of next-generation engineering materials. Tooth enamel is a viable candidate, but variations in the structure and properties of enamel across taxa have not been explored. Here, teeth from six different mammalian species were categorized according to their bite force quotient (BFQ), and the enamel was compared in terms of selected chemical, microstructural, and mechanical properties. We show that specific aspects of the chemical composition and properties of the Low and High BFQ groups are unique, which appears reflective of bite forces associated with diet and predation. Overall, the results highlight that the diversity of tooth enamel across species should be considered in the pursuit of nature-inspired structural materials.

Tooth structure, mechanical properties, and diet specialization of Piranha and Pacu (Serrasalmidae): A comparative study

The relationship between diet, bite performance, and tooth structure is a topic of common interest for ecologists, biologists, materials scientists, and engineers. The highly specialized group of biters found in Serrasalmidae offers a unique opportunity to explore their functional diversity. Surprisingly, the piranha, whose teeth have a predominantly cutting function and whose main diet is soft flesh, is capable of exerting a greater bite force than a similarly sized pacu, who feeds on a hard durophagous diet. Herein, we expand our understanding of diet specialization in the Serrasalmidae family by investigating the influence of elemental composition and hierarchical structure on the local mechanical properties, stress distribution, and deformation mechanics of teeth from piranha (Pygocentrus nattereri) and pacu (Colossoma macropomum). Microscopic and spectroscopic analyses combined with nanoindentation and finite element simulations are used to probe the hierarchical features to uncover the structure-property relationships in piranha and pacu teeth. We show that the pacu teeth support a durophagous diet through its broad cusped-shaped teeth, thicker-irregular enameloid, interlocking interface of the dentin-enameloid junction, and increased hardness of the cuticle layer due to the larger concentrations of iron present. Comparatively, the piranha teeth are well suited for piercing due to their conical-shape which we report as having the greatest stiffness at the tip and evenly distributed enameloid. STATEMENT OF SIGNIFICANCE: The hierarchical structure and local mechanical properties of the piranha and pacu teeth are characterized and related to their feeding habits. Finite element models of the anterior teeth are generated to map local stress distribution under compressive loading. Bioinspired designs from the DEJ interface are developed and 3D printed. The pacu teeth are hierarchically structured and have local mechanical properties more suitable to a durophagous diet than the piranha. The findings here can provide insight into the design and fabrication of layered materials with suture interfaces for applications that require compressive loading conditions.

Effect of the different debonding strength of metal and ceramic brackets on the degree of enamel microcrack healing

Objective:

This study aims to determine shear debonding strength of metal and ceramic brackets, and the degree of enamel crack healing.

Material and Methods:

Extracted human maxillary premolars were flattened on the buccal surface, and randomly separated into five groups (n = 15). In control groups (groups 1 and 2), metal and ceramic brackets were bonded on flat polished enamel, while in experimental groups (groups 3 and 4), metal and ceramic brackets were bonded on the surface with boundary where corner cracks were created. Additionally, fifteen specimens (group 5) were also prepared for an indentation procedure with no bracket installation. The degree of crack healing was measured. All brackets were detached with a universal testing machine, and the adhesive remnant index (ARI) was also identified. Healing degree and apparent fracture toughness were then calculated.

Results:

Between groups with similar bracket types, there was no statistically significant difference in debonding strength. Regarding bracket types, ceramic brackets provided significantly higher debonding strength than metal brackets. There was a significant difference in ARI scores between metal and ceramic brackets. The corner cracks showed signs of healing in both horizontal and vertical directions. No statistically significant difference in the healing rates among the groups was found and the apparent fracture toughness increased from the initial to the final measurement.

Conclusions:

Within the limitations of this study, even though ceramic brackets required significantly higher debonding force compared to metal brackets, debonding stress was limited to the bonding site and did not affect the surrounding cracks on enamel.

Fracture toughness of the stomatopod dactyl club is enhanced by plastic dissipation: A fracture micromechanics study

The dactyl club of stomatopods is a biological hammer used to strike on hard-shell preys. To serve its function, the club must be imparted with a high tolerance against both contact stresses and fracture. While the contact mechanics of the club has been established, fracture toughness characterization has so far remained more elusive and semi-quantitative using nanoindentation fracture methods. Here, we used microcantilever fracture specimens with a chevron-notched crack geometry to quantitatively evaluate the fracture response of the impact region of dactyl clubs. The chevron-notched geometry was selected as it minimizes surface-related artefacts due to ion milling, and further allows to carry out fracture tests on samples free of pre-cracks with stable crack propagation even for brittle materials. Both linear elastic as well as elastic-plastic fracture mechanics methods, together with finite element modelling, were employed to analyse the fracture data. We find that crack-tip plastic dissipation is the main mechanism contributing to the fracture properties of the dactyl club material. Our study also suggests that the chevron-notched crack geometry is a suitable method to quantitatively assess the fracture toughness of hard biological materials. STATEMENT OF SIGNIFICANCE: Characterizing the fracture resistance of biomineralized structures is essential to draw their structure-properties relationships. Yet measuring the fracture properties of such materials is often hampered by their small size and irregular shape. Indentation fracture is used to circumvent these issues but does not discriminate between the elastic and elastic-plastic contributions to the fracture resistance. The dactyl club "hammer" of mantis shrimps is a biological material whose fracture properties are central to its function. A microfracture study was conducted using microcantilever specimens with chevron-notched crack geometry to assess the fracture toughness. Adopting linear elastic and elastic-plastic fracture mechanics protocols, we find that plastic dissipation is the major contribution to the fracture response of the hypermineralized impact region of the dactyl club.

Wear mechanism of human tooth enamel: The role of interfacial protein bonding between HA crystals

Human tooth enamel, the most mineralized tissue in body, contains less than 2 wt% protein. Consequently, the importance of the protein to enamel mechanical response has always been overlooked. In this study, the role of minor protein in providing enamel microstructure and mechanical performance, especially tribological properties, were studied using deproteinization treatment and nano-indentation/scratch technique. Via the change from the original to the deproteinated conditions, a nanostructure degeneration from the assembly of hydroxyapatite (HA) crystals into nano-fibers to crystal aggregation has been found between the high-wear-resistance and low-wear-resistance on the enamel surface. Correspondingly, an energy dissipation to cause a unit volume of wear on enamel surface decreases by 50%, and wear volume increases by 80%. With the presence of protein, the occurrence of enamel wear requires to break the interfacial protein bonding between the HA crystals in nano-fibers and the break dissipates considerable energy, which benefits the enamel to resist wear. Thus, the protein in enamel, although of a very low content, is essential to resisting wear by mediating the assembly of rigid HA crystals via interfacial protein bonding. Replicating functions of the protein component will be critical to the successful development of bio-inspired materials that are designed for wear-resistance.

Nature's design solutions in dental enamel: Uniting high strength and extreme damage resistance

The most important demand of today's high-performance materials is to unite high strength with extreme fracture toughness. The combination of withstanding large forces (strength) and resistance to fracture (toughness), especially preventing catastrophic material failure by cracking, is of utmost importance when it comes to structural applications of these materials. However, these two properties are commonly found to be mutually exclusive: strong materials are brittle and tough materials are soft. In dental enamel, nature has combined both properties with outstanding success - despite a limited number of available constituents. Made up of brittle mineral crystals arranged in a sophisticated hierarchical microstructure, enamel exhibits high stiffness and excellent toughness. Different species exhibit a variety of structural adaptations on varying scales in their dental enamel which optimise not only fracture toughness, but also hardness and abrasion behaviour. Nature's materials still outperform their synthetic counterparts due to these complex structure-property relationships that are not yet fully understood. By analysing structure variations and the underlying mechanical mechanisms systematically, design principles which are the key for the development of advanced synthetic materials uniting high strength and toughness can be formulated. STATEMENT OF SIGNIFICANCE: Dental enamel is a hard protective tissue that combines high strength with an exceptional resistance to catastrophic fracture, properties that in classical materials are commonly found to be mutually exclusive. The biological material is able to outperform its synthetic counterparts due to a sophisticated hierarchical microstructure. Between different species, microstructural adaptations can vary significantly. In this contribution, the different types of dental enamel present in different species are reviewed and connections between microstructure and (mechanical) properties are drawn. By consolidating available information for various species and reviewing it from a materials science point of view, design principles for the development of advanced biomimetic materials uniting high strength and toughness can be formulated.

Enamel chipping in Taï Forest cercopithecids: Implications for diet reconstruction in paleoanthropological contexts

Antemortem enamel chipping in living and fossil primates is often interpreted as evidence of hard-object feeding (i.e., 'durophagy'). Laboratory analyses of tooth fracture have modeled the theoretical diets and loading conditions that may produce such chips. Previous chipping studies of nonhuman primates tend to combine populations into species samples, despite the fact that species can vary significantly in diet across their ranges. Chipping is yet to be analyzed across population-specific species samples for which long-term dietary data are available. Here, we test the association between enamel chipping and diet in a community of cercopithecid primates inhabiting the Taï Forest, Ivory Coast. We examined fourth premolars and first molars (n = 867) from naturally deceased specimens of Cercocebus atys, Colobus polykomos, Piliocolobus badius,Procolobus verus, and three species of Cercopithecus. We found little support for a predictive relationship between enamel chipping and diet across the entire Taï monkey community. Cercocebus atys, a dedicated hard-object feeder, exhibited the highest frequencies of (1) chipped teeth and (2) chips of large size; however, the other monkey with a significant degree of granivory, Co. polykomos, exhibited the lowest chip frequency. In addition, primates with little evidence of mechanically challenging or hard-food diets-such as Cercopithecus spp., Pi. badius, and Pr. verus-evinced higher chipping frequencies than expected. The equivocal and stochastic nature of enamel chipping in the Taï monkeys suggests nondietary factors contribute significantly to chipping. A negative association between canopy preference and chipping suggests a role of exogenous particles in chip formation, whereby taxa foraging closer to the forest floor encounter more errant particulates during feeding than species foraging in higher strata. We conclude that current enamel chipping models may provide insight into the diets of fossil primates, but only in cases of extreme durophagy. Given the role of nondietary factors in chip formation, our ability to reliably reconstruct a range of diets from a gradient of chipping in fossil taxa is likely weak.

The geometrical structure of interfaces in dental enamel: A FIB-STEM investigation

In this study a high resolution structural analysis revealed that enamel prisms are surrounded by an interface that is discontinuous with frequent mineral to mineral contact separated by gaps. This contact manifests either by crystallites bridging the boundary between prismatic and interprismatic enamel or continuous crystallites curving and bridging the interprismatic enamel to the prisms. The geometrical resolution of this TEM investigation of the interfaces is ≤2 nm as a basis for micromechanical models. Within this resolution, contrary to existing structural descriptions of dental enamel structure in materials science literature, here the crystallites themselves are shown to be either in direct contact with each other, sometimes even fusing together, or are separated by gaps. Image analysis revealed that on average only 57 ± 15% of the interface consists of points of no contact between crystallites. This work reveals structural features of dental enamel that contribute important understanding to both the architecture and mechanical properties of this biological material. A new structural model is proposed and the implications for the mechanical properties of dental enamel are discussed. STATEMENT OF SIGNIFICANCE: In this study a high resolution structural analysis, employing focused ion beam and transmission electron microscopy revealed that enamel prisms are surrounded by interfaces that are discontinuous with frequent mineral to mineral contact separated by gaps. Although the interfaces in enamel have been investigated previously, existing studies are lacking in detail considering the geometry and morphology of the interfaces. We think that this result is of great importance when it comes to the understanding of the mechanical properties. In our opinion the concept of soft sheaths is no longer feasible. The resulting observations are included in a new structural model which provides new qualitative insights into the mechanical behavior. Existing analytical models were applied to simulate the new geometrical structure.

Breaking crown dentine in whole teeth: 3D observations of prevalent fracture patterns following overload

Teeth with intact crowns rarely split or fracture, despite decades of cyclic loading and occasional unexpected overload. This is largely attributed to the presence of dentine, since cracking and fracture of enamel have been frequently reported. Dentine is similar to bone, comprising mineralised collagen fibres as a main constituent. Unlike cortical bone, however, where microcracking and damage arrest are essential for re/modelling and healing, dentine can neither remodel nor regenerate. This raises questions regarding the evolutionary benefits of toughening, leading to uncertainty whether cracks actually appear in dentine in situ. Here we study the notion that circumpulpal dentine is usually protected against, rather than damaged by severe overloads, even though it is not much more massive or stronger than it needs to be. To address this, we examined hydrated teeth still within whole jawbones of freshly-slaughtered skeletally mature pigs, mechanically loaded until fracture. Force displacement curves, optical and electron microscopy combined with 3D microstructural analysis by conventional micro-computed tomography (μCT) revealed mostly brittle fracture paths in circumpulpal crown dentine. Once overload cracks reach this mass of dentine they propagate rapidly along straight paths often parallel to the enamel flanks of the oblong shovel shaped premolars. We find infrequent signs of active toughening mechanisms with minimal crack diversion, ligament bridging and microcracking. When such toughening is seen, it mainly appears in softer dentine in the root, or near the dentine-enamel-junction (DEJ) in mantle dentine. We observed shear bands in overloaded circumpulpal dentine, due to mutual gliding of upper and lower segments. These shear bands are formed as periodic arrays of rotated dentine fragments. The 3D data consistently demonstrate the importance of the layered tooth structure, containing a stiff outer enamel shell, a soft sub-DEJ interlayer and a stiff circumpulpal dentine bulk, for deflecting cracks from splitting the tooth.

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.

Hierarchy structure and fracture mechanisms of the wild wolf tusk's enamel

The self-growth and self-strengthening of natural biomaterials provided us strategies for new materials design. In this paper, the microstructure and fracture mechanisms of the wild wolf tusk's enamel were studied. The enamel included four-order hierarchies, which were the hydroxyapatite (HAP) fiber (first-order, nano-scale, ploy-crystals), enamel rod (second-order, micro-scale, rope-like), enamel type (third-order, meso-scale, mat-like) and the enamel patterns (forth-order, macro-scale), respectively. It was interesting to find that the numerous nano-grains distributed disorderly in a single HAP fiber. The thousands HAP fibers bundled together to form the rope-like enamel rod. The protein ligaments were discovered between adjacent enamel rods. The out enamel, inner enamel and P&D-zones showed a criss-cross type and ran through whole enamel pattern in three-dimensional space. The enamel of the wild wolf tusk exhibited an excellent fracture toughness based on the nanoindentation tests. The fracture morphology in transverse direction indicated that the cracks preferred to propagate along the weak interface (protein or interrod) and cut those enamel rods perpendicular to the propagation direction. However, the cracks extended obviously forward along the step-like paths from the outmost surface of the enamel to the enamel-dentin junction in the longitudinal direction. It was considered that the protein ligament was the main reason for the good fracture toughness of the bulk enamel. Our studies reveal that the design strategies of the natural material can be applied to guide the development of high-performance artificial materials.

The Materials of Mastication: Material Science of the Humble Tooth

Dental functional morphology, as a field, represents a confluence of materials science and biology. Modern methods in materials testing have been influential in driving the understanding of dental tissues and tooth functionality. Here we present a review of dental enamel, the outermost tissue of teeth. Enamel is the hardest biological tissue and exhibits remarkable resilience even when faced with a variety of mechanical threats. In the light of recent work, we progress the argument that the risk of mechanical degradation across multiple scales exhibits a strong and continued selection pressure on structural organization of enamel. The hierarchical nature of enamel structure presents a range of scale-dependent toughening mechanisms and provides a means by which natural selection can drive the specialization of this tissue from nanoscale reorganization to whole tooth morphology. There has been much learnt about the biomechanics of enamel recently, yet our understanding of the taxonomic diversity of this tissue is still lacking and may form an interesting avenue for future research.

Unlocalized crack initiation and propagation in staggered biomaterials

Many types of tissues in living organisms exhibit a combination of different properties to fulfil their mechanical functions in complex environments. Nacre with more than 90% brittle and hard phase and a little protein matrix, exhibits high strength and toughness, which is difficult to achieve in artificial materials. Researchers have shown that the toughness of nacre is related to the cracking process. Most of them, however, assume an obvious pre-existing crack on the model and the initiation of the microscopical pre-existing crack is not considered yet. Based on fracture mechanics with the cohesive zone model, we reveal the mechanism of the crack initiation and propagation pattern in staggered biomaterials without any pre-existing crack. The simulation result shows that there are two crack propagation modes: localized mode and unlocalized mode. A crack initiates and propagates in a small area in the localized mode, while cracks initiate at different points and propagate in various paths in the unlocalized mode. The crack initiation mechanism from the intrinsic properties of the material is clarified using energy based stability analysis. The result shows that the shear interfacial mechanism significantly delays the crack initiation.

Hydration-induced nano- to micro-scale self-recovery of the tooth enamel of the giant panda

The tooth enamel of vertebrates comprises a hyper-mineralized bioceramic, but is distinguished by an exceptional durability to resist impact and wear throughout the lifetime of organisms; however, enamels exhibit a low resistance to the initiation of large-scale cracks comparable to that of geological minerals based on fracture mechanics. Here we reveal that the tooth enamel, specifically from the giant panda, is capable of developing durability through counteracting the early stage of damage by partially recovering its innate geometry and structure at nano- to micro- length-scales autonomously. Such an attribute results essentially from the unique architecture of tooth enamel, specifically the vertical alignment of nano-scale mineral fibers and micro-scale prisms within a water-responsive organic-rich matrix, and can lead to a decrease in the dimension of indent damage in enamel introduced by indentation. Hydration plays an effective role in promoting the recovery process and improving the indentation fracture toughness of enamel (by ∼73%), at a minor cost of micro-hardness (by ∼5%), as compared to the dehydrated state. The nano-scale mechanisms that are responsible for the recovery deformation, specifically the reorientation and rearrangement of mineral fragments and the inter- and intra-prismatic sliding between constituents that are closely related to the viscoelasticity of organic matrix, are examined and analyzed with respect to the structure of tooth enamel. Our study sheds new light on the strategies underlying Nature's design of durable ceramics which could be translated into man-made systems in developing high-performance ceramic materials. STATEMENT OF SIGNIFICANCE: Tooth enamel plays a critical role in the function of teeth by providing a hard surface layer to resist wear/impact throughout the lifetime of organisms; however, such enamel exhibits a remarkably low resistance to the initiation of large-scale cracks, of hundreds of micrometers or more, comparable to that of geological minerals. Here we reveal that tooth enamel, specifically that of the giant panda, is capable of partially recovering its geometry and structure to counteract the early stages of damage at nano- to micro-scale dimensions autonomously. Such an attribute results essentially from the architecture of enamel but is markedly enhanced by hydration. Our work discerns a series of mechanisms that lead to the deformation and recovery of enamel and identifies a unique source of durability in the enamel to accomplish this function. The ingenious design of tooth enamel may inspire the development of new durable ceramic materials in man-made systems.

Investigation on the Gradient Nanomechanical Behavior of Dental Fluorosis Enamel

This study aims to investigate the gradient nanomechanical behavior of dental fluorosis enamel and provide appropriate selection criteria for restorative materials. The nanomechanical properties of the outer, middle, and inner layers of normal tooth enamel, mild dental fluorosis enamel, and severe dental fluorosis enamel were tested by nanoindentation under an applied load of 2000 μN and holding time of 30 s. The nanotribological properties were then evaluated through nanoscratch tests under an applied load of 1000 μN. In addition, the nanotribological property of the outer layer of dental fluorosis enamel was compared with that of four restorative materials, namely, lithium disilicate glass-ceramic (IPS e.max CAD), polymer-infiltrated-ceramic network (PICN), composite resin block (Lava™ ultimate), and conventional composite resin (Fltek™ Z350XT). The nanohardness and elastic modulus of mild dental fluorosis enamel increased from the outer to the middle layers and then decreased from the middle to the inner layers. By contrast, the changed displacement, friction coefficient, and nanoscratch depth and width decreased from the outer to the middle layers and then increased from the middle to the inner layers. In severe dental fluorosis enamel, nanohardness and elastic modulus increased from the outer to the inner layers, but the changed displacement, friction coefficient, and nanoscratch depth and width decreased from the outer to the inner layers. The nanoscratch depth and width of Lava™ ultimate were similar to those of the outer layer of the mild dental fluorosis enamel. The gradient nanomechanical behavior of dental fluorosis enamel significantly differed from that of normal tooth enamel. Dental materials with a wear resistance similar to that of the opposing enamel are a good choice for restoring dental fluorosis (trial registration: WCHSIRB-D-2014-126, registered 25 December 2014).

Tough and deformable glasses with bioinspired cross-ply architectures

Glasses are optically transparent, hard materials that have been in sustained demand and usage in architectural windows, optical devices, electronics and solar panels. Despite their outstanding optical qualities and durability, their brittleness and low resistance to impact still limits wider applications. Here we present new laminated glass designs that contain toughening cross-ply architectures inspired from fish scales and arthropod cuticles. This seemingly minor enrichment completely transforms the way laminated glass deforms and fractures, and it turns a traditionally brittle material into a stretchy and tough material with little impact on surface hardness and optical quality. Large ply rotation propagates over large volumes, and localization is delayed in tension, even if a strain softening interlayer is used, in a remarkable mechanism which is generated by the kinematics of the plies and geometrical hardening. Compared to traditional laminated glass which degrades significantly in performance when damaged, our cross-ply architecture glass is damage-tolerant and 50 times tougher in energy terms.

STATEMENT OF SIGNIFICANCE

Despite the outstanding optical qualities and durability of glass, its brittleness and low resistance to impact still limits its wider application. Here we present new laminated glass designs that contain toughening cross-ply architectures inspired from fish scales and arthropod cuticles. Enriching laminated designs with crossplies completely transforms the material deforms and fractures, and turns a traditionally brittle material into a stretchy and tough material - with little impact on surface hardness and optical quality. Large ply rotation propagates over large volumes and localization is delayed in tension because of a remarkable and unexpected geometrical hardening effect. Compared to traditional laminated glass which degrades significantly in performance when damaged, our cross-ply architecture glass is damage-tolerant and it is 50 times tougher in energy terms. Our glass-based, transparent material is highly innovative and it is the first of its kind. We believe it will have impact in broad range of applications in construction, coatings, chemical engineering, electronics, photovoltaics.

The Tooth: Its Structure and Properties

This article provides a brief review of recent investigations concerning the structure and properties of the tooth. The last decade has brought a greater emphasis on the durability of the tooth, an improved understanding of the fatigue and fracture behavior of the principal tissues, and their importance to tooth failures. The primary contributions to tooth durability are discussed, including the process of placing a restoration, the impact of aging, and challenges posed by the oral environment. The significance of these findings to the dental community and their importance to the pursuit of lifelong oral health are highlighted.

Enamel Microcracks Induced by Simulated Occlusal Wear in Mature, Immature, and Deciduous Teeth

Enamel wear, which is inevitable due to the process of mastication, is a process in which the microcracking of enamel occurs due to the surface contacting very small hard particles. When these particles slide on enamel, a combined process of microcutting and microcracking in the surface and subsurface of the enamel takes place. The aim of this study was to detect microscopic differences in the microcrack behavior by subjecting enamel specimens derived from different age groups (immature open-apex premolars, mature closed-apex premolars, and deciduous molars) to cycles of simulated impact and sliding wear testing under controlled conditions. Our findings indicated that the characteristics of the microcracks, including the length, depth, count, orientation, and relation to microstructures differed among the study groups. The differences between the surface and subsurface microcrack characteristics were most notable in the enamel of deciduous molars followed by immature premolars and mature premolars whereby deciduous enamel suffered numerous, extensive, and branched microcracks. Within the limitations of this study, it was concluded that enamel surface and subsurface microcracks characteristics are dependent on the posteruptive age with deciduous enamel being the least resistant to wear based on the microcrack behavior as compared to permanent enamel.

Enamel apatite crystallinity significantly contributes to mammalian dental adaptations

The monophyodont molar teeth, prismatic enamel and the complexity of enamel microarchitecture are regarded as essential dental apomorphies of mammals. As prominent background factors of feeding efficiency and individual longevity these characters are crucial components of mammalian adaptive dynamics. Little is known, however, to which degree these adaptations are influenced by the crystallographic properties of elementary hydroxyapatite crystallites, the only inorganic component of enamel. In a miniature pig where individual molars differ significantly in duration of their development and in enamel resistance to attrition stress, we found highly significant differences between the molars in the size of crystallites, amount of microstrain, crystallinity and in enamel stiffness and elasticity, all clearly scaled with the duration of tooth calcification. The same pattern was found also in red deer bearing different molar type. The results suggest that the prolongation of tooth development is associated with an increase of crystallinity, i.e. the atomic order of enamel hydroxyapatite, an obvious component of micromechanical property of mature enamel. This relation could contribute to prolongation of dental development, characteristic of mammals in general. The aspects of enamel crystallinity, omitted in previous studies on mammalian and vertebrate dental evolution, are to be taken in account in these topics.

Computational Modeling of Interfacial Behaviors in Nanocomposite Materials

Towards understanding the bulk material response in nanocomposites, an interfacial zone model was proposed to define a variety of material interface behaviors (e.g. brittle, ductile, rubber-like, elastic-perfectly plastic behavior etc.). It also has the capability to predict bulk material response though independently control of the interface properties (e.g. stiffness, strength, toughness). The mechanical response of granular nanocomposite (i.e. nacre) was investigated through modeling the "relatively soft" organic interface as an interfacial zone among "hard" mineral tablets and simulation results were compared with experimental measurements of stress-strain curves in tension and compression tests. Through modeling varies material interfaces, we found out that the bulk material response of granular nanocomposite was regulated by the interfacial behaviors. This interfacial zone model provides a possible numerical tool for qualitatively understanding of structure-property relationships through material interface design.

Structural Analysis of Enamel in Teeth from Head-and-Neck Cancer Patients Who Underwent Radiotherapy

Objective: To analyze macroscopic, microscopic, and ultrastructural aspects of enamel from head-and-neck cancer patients submitted to radiotherapy. Materials and Methods: Twenty sound extracted permanent molars were used and divided into 2 groups. The experimental group consisted of 10 molars from head-and-neck cancer patients submitted to radiotherapy with total doses that ranged from 50 to 70 Gy. Ten molars from patients who did not receive radiotherapy were matched with experimental-group samples by anatomic tooth group and comprised the control group. To perform a macroscopic analysis, standardized photos of different enamel faces were taken with a camera. Teeth were subjected to longitudinal cuts and hand polished to a final thickness of 0.1 mm. Enamel was analyzed under polarized light microscopy, and optical retardation values of birefringence were calculated in cervical, cusp, and occlusal pit areas. Subsequently, the same enamel areas were analyzed by scanning electron microscopy. Data from optical retardation values were statistically analyzed by 2-way ANOVA and Fisher's test (α < 0.05). Results: No macroscopic differences were observed between the irradiated and control groups. Polarized light microscopy analysis revealed that cervical enamel exhibited darker areas characterized by discrete birefringence patterns compared to the control enamel. Optical retardation values were only significantly different in the cervical enamel of the irradiated and control groups (p < 0.0001). Scanning electron microscopy analysis revealed more evident interprismatic spaces in the cervical and outer cusp enamel of irradiated samples. Conclusions: Head-and-neck radiotherapy reduced optical retardation values of birefringence in cervical enamel, and the interprismatic spaces became more evident.

Initial and long-term bond strengths of one-step self-etch adhesives with silane coupling agent to enamel-dentin-composite in combined situation

This study evaluated the effect of adding silane coupling agent on initial and long-term bond strengths of one-step self-etch adhesives to enamel-dentin-composite in combined situation. Cervical cavities were prepared on extracted molars and filled with Clearfil AP-X. After water-storage for one-week, the filled teeth were sectioned in halves to expose enamel, dentin and composite surfaces and then enamel-dentin-composite surface was totally applied with one of adhesive treatments (Clearfil SE One, Clearfil SE One with Clearfil Porcelain Bond Activator, Beautibond Multi, Beautibond Multi with Beautibond Multi PR Plus and Scotchbond Universal). After designed period, micro-shear bond strengths (µSBSs) to each substrate were determined. For each period of water-storage, additive silane treatments significantly increased µSBS to composite (p<0.001). On the other hand, they significantly decreased µSBS to dentin (p<0.001), although did not have adverse effect on µSBS to enamel (p>0.05). Moreover, the stability of µSBS was depended on materials and substrates used.

Degradation in the fatigue crack growth resistance of human dentin by lactic acid

The oral cavity frequently undergoes localized changes in chemistry and level of acidity, which threatens the integrity of the restorative material and supporting hard tissue. The focus of this study was to evaluate the changes in fatigue crack growth resistance of dentin and toughening mechanisms caused by lactic acid exposure. Compact tension specimens of human dentin were prepared from unrestored molars and subjected to Mode I opening mode cyclic loads. Fatigue crack growth was achieved in samples from mid- and outer-coronal dentin immersed in either a lactic acid solution or neutral conditions. An additional evaluation of the influence of sealing the lumens by dental adhesive was also conducted. A hybrid analysis combining experimental results and finite element modeling quantified the contribution of the toughening mechanisms for both environments. The fatigue crack growth responses showed that exposure to lactic acid caused a significant reduction (p≤0.05) of the stress intensity threshold for cyclic crack extension, and a significant increase (p≤0.05) in the incremental fatigue crack growth rate for both regions of coronal dentin. Sealing the lumens had negligible influence on the fatigue resistance. The hybrid analysis showed that the acidic solution was most detrimental to the extrinsic toughening mechanisms, and the magnitude of crack closure stresses operating in the crack wake. Exposing dentin to acidic environments contributes to the development of caries, but it also increases the chance of tooth fractures via fatigue-related failure and at lower mastication forces.

Erosion protection conferred by whole human saliva, dialysed saliva, and artificial saliva

During dental erosion, tooth minerals are dissolved, leading to a softening of the surface and consequently to irreversible surface loss. Components from human saliva form a pellicle on the tooth surface, providing some protection against erosion. To assess the effect of different components and compositions of saliva on the protective potential of the pellicle against enamel erosion, we prepared four different kinds of saliva: human whole stimulated saliva (HS), artificial saliva containing only ions (AS), human saliva dialysed against artificial saliva, containing salivary proteins and ions (HS/AS), and human saliva dialysed against deionised water, containing only salivary proteins but no ions (HS/DW). Enamel specimens underwent four cycles of immersion in either HS, AS, HS/AS, HS/DW, or a humid chamber (Ctrl), followed by erosion with citric acid. During the cycling process, the surface hardness and the calcium released from the surface of the specimens were measured. The different kinds of saliva provided different levels of protection, HS/DW exhibiting significantly better protection than all the other groups (p < 0.0001). Different components of saliva, therefore, have different effects on the protective properties of the pellicle and the right proportions of these components in saliva are critical for the ability to form a protective pellicle.

Keratins as components of the enamel organic matrix

Dental enamel is the hardest tissue in the human body, and although it starts as a tissue rich in proteins, by the time of eruption of the tooth in the oral cavity only a small fraction of the protein remains. While this organic matrix of enamel represents less than 1% by weight it plays essential roles in improving both toughness and resilience to chemical attacks. Despite the fact that the first studies of the enamel matrix began in the 19th century, its exact composition and mechanisms of its function remain poorly understood. It was proposed that keratin or a keratin-like primitive epithelial component exists in mature enamel, however due to the extreme insolubility of its organic matrix the presence of keratins there was never clearly established. We have recently identified expression of a number of hair keratins in ameloblasts, the enamel secreting cells, and demonstrated their incorporation into mature enamel. Mutation in epithelial hair keratin KRT75 leads to a skin condition called pseudofollicularis barbae. Carriers of this mutation have an altered enamel structure and mechanical properties. Importantly, these individuals have a much higher prevalence of caries. To the best of our knowledge, this is the first study showing a direct link between a mutation in a protein-coding region of a gene and increased caries rates. In this paper we present an overview of the evidence of keratin-like material in enamel that has accumulated over the last 150years. Furthermore, we propose potential mechanisms of action of KTR75 in enamel and highlight the clinical implications of the link between mutations in KRT75 and caries. Finally, we discuss the potential use of keratins for enamel repair.

On the importance of aging to the crack growth resistance of human enamel

With improvements in oral health and an overall increase in quality of life, the percentage of fully or largely dentate seniors is increasing. Understanding the effects of aging on the mechanical properties of teeth is essential to the maintenance of lifelong oral health. In this investigation the effects of aging on the fracture toughness of human enamel were evaluated from incremental crack growth experiments performed on tissue of donor teeth representing "young" (17 ⩽ age ⩽ 25) and "old" (age ⩾ 55) age groups. Results showed that the old enamel exhibited significantly lower resistance to fracture than that of the young tissue in two orthogonal directions of crack growth. For crack growth transverse to the enamel rods, the fracture toughness of the old enamel (0.37 ± 0.15 MPa m(0.5)) was nearly 70% lower than that of tissue from the young teeth (1.23 ± 0.20 MPa m(0.5)). Based on results from a mechanistic analysis of crack growth, the reduction in fracture resistance is attributed to a decrease in the degree of extrinsic toughening. The practice of restorative dentistry should account for these changes in tooth tissues in the treatment of senior patients.

STATEMENT OF SIGNIFICANCE

The mechanical behavior of enamel has been studied for over 3 decades. Due to the limited volume of tissue available for evaluation, past work has been largely based on indentation methods. In this investigation we have evaluated the resistance to fracture of human enamel using a conventional fracture mechanics approach and incremental crack growth. We compared the fracture resistance of cuspal enamel obtained from the teeth of representative "young" and "old" donor groups. Our results show that there is a substantial reduction in the resistance to fracture with age, that it is anisotropic, and that the degradation is more severe than that which occurs to dentin. As such, we feel this work is a significant contribution to the field.

The effect of enamel proteins on erosion

Enamel proteins form a scaffold for growing hydroxyapatite crystals during enamel formation. They are then almost completely degraded during enamel maturation, resulting in a protein content of only 1% (w/v) in mature enamel. Nevertheless, this small amount of remaining proteins has important effects on the mechanical and structural properties of enamel and on the electrostatic properties of its surface. To analyze how enamel proteins affect tooth erosion, human enamel specimens were deproteinated. Surface microhardness (SMH), surface reflection intensity (SRI) and calcium release of both deproteinated and control specimens were monitored while continuously eroding them. The deproteination itself already reduced the initial SMH and SRI of the enamel significantly (p < 0.001 and p < 0.01). During the course of erosion, the progression of all three evaluated parameters differed significantly between the two groups (p < 0.001 for each). The deproteinated enamel lost its SMH and SRI faster, and released more calcium than the control group, but these differences were only significant at later stages of erosion, where not only surface softening but surface loss can be observed. We conclude that enamel proteins have a significant effect on erosion, protecting the enamel and slowing down the progression of erosion when irreversible surface loss starts to occur.