Regeneration of biomimetic hydroxyapatite on etched human enamel by anionic PAMAM template in vitro

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.

Effect of phosphate group on remineralization of early enamel caries regulated by amelogenin peptide

OBJECTIVE

To show the effect of the phosphate group on the remineralization process of early enamel caries mediated by amelogenin peptide.

METHODS

Freshly extracted, completed, and crack-free bovine teeth were used to create artificial early enamel caries, which were randomly divided into four groups: Group A: fluorination remineralized solution treatment group; Group B: pure remineralized solution treatment group. Group C: 100 g/ml recombinant Amelogenin peptide remineralized solution treatment group (with single phosphate group on N-terminus); Group D: 100 g/ml non-phosphorylated recombinant Amelogenin peptide remineralized solution treatment group (without single phosphate group on N-terminus). For 12 days, fresh remineralized solutions were replaced daily. Transverse microradiography (TMR) was used after remineralization to determine mineral loss and demineralization depth before and after each sample's remineralization. Each sample's depth of remineralization and mineral acquisition were then determined.

RESULTS

The recombinant amelogenin peptide group significantly outperformed the non-phosphorylated amelogenin peptide group in terms of mineral acquisition and mineralization depth (P<0.05).

CONCLUSIONS

The recombinant Amelogenin's solitary phosphate group at the N-terminus helps recombinant Amelogenin to encourage the remineralization process of early enamel caries.

Biomimetic Self-Maturation Mineralization System for Enamel Repair

Enamel repair is crucial for restoring tooth function and halting dental caries. However, contemporary research often overlooks the retention of organic residues within the repair layer, which hinders the growth of dense crystals and compromises the properties of the repaired enamel. During the maturation of natural enamel, the organic matrix undergoes enzymatic processing to facilitate further crystal growth, resulting in a highly mineralized tissue. Inspired by this process, a biomimetic self-maturation mineralization system is developed, comprising ribonucleic acid-stabilized amorphous calcium phosphate (RNA-ACP) and ribonuclease (RNase). The RNA-ACP induces initial mineralization in the form of epitaxial crystal growth, while the RNase present in saliva automatically triggers a biomimetic self-maturation process. The mechanistic study further indicates that RNA degradation prompts conformational rearrangement of the RNA-ACP, effectively excluding the organic matter introduced earlier. This exclusion process promotes lateral crystal growth, resulting in the generation of denser enamel-like apatite crystals that are devoid of organic residues. This strategy of eliminating organic residues from enamel crystals enhances the mechanical and physiochemical properties of the repaired enamel. The present study introduces a conceptual biomimetic mineralization strategy for effective enamel repair in clinical practice and offers potential insights into the mechanisms of biomineral formation.

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.

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.

Dental plaque-inspired versatile nanosystem for caries prevention and tooth restoration

Dental caries is one of the most prevalent human diseases resulting from tooth demineralization caused by acid production of bacteria plaque. It remains challenges for current practice to specifically identify, intervene and interrupt the development of caries while restoring defects. In this study, inspired by natural dental plaque, a stimuli-responsive multidrug delivery system (PMs@NaF-SAP) has been developed to prevent tooth decay and promote enamel restoration. Classic spherical core-shell structures of micelles dual-loaded with antibacterial and restorative agents are self-assembled into bacteria-responsive multidrug delivery system based on the pH-cleavable boronate ester bond, followed by conjugation with salivary-acquired peptide (SAP) to endow the nanoparticle with strong adhesion to tooth enamel. The constructed PMs@NaF-SAP specifically adheres to tooth, identifies cariogenic conditions and intelligently releases drugs at acidic pH, thereby providing antibacterial adhesion and cariogenic biofilm resistance, and restoring the microarchitecture and mechanical properties of demineralized teeth. Topical treatment with PMs@NaF-SAP effectively diminishes the onset and severity of caries without impacting oral microbiota diversity or surrounding mucosal tissues. These findings demonstrate this novel nanotherapy has potential as a promising biomedical application for caries prevention and tooth defect restoration while resisting biofilm-associated diseases in a controlled manner activated by pathological bacteria.

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Nanomaterials can adhere to tooth and target acidic biofilms specifically.

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Application of caries prevention and tooth defect restoration.

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Guidance for the innovation of the existing post-defect restoration strategies.

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The multidrug delivery system exerts antibacterial and restorative abilities on demand.

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Bacteria-responsive system resists biofilm-associated diseases in a controlled manner.

Biomimetic Nanomaterials: Diversity, Technology, and Biomedical Applications

Biomimetic nanomaterials (BNMs) are functional materials containing nanoscale components and having structural and technological similarities to natural (biogenic) prototypes. Despite the fact that biomimetic approaches in materials technology have been used since the second half of the 20th century, BNMs are still at the forefront of materials science. This review considered a general classification of such nanomaterials according to the characteristic features of natural analogues that are reproduced in the preparation of BNMs, including biomimetic structure, biomimetic synthesis, and the inclusion of biogenic components. BNMs containing magnetic, metal, or metal oxide organic and ceramic structural elements (including their various combinations) were considered separately. The BNMs under consideration were analyzed according to the declared areas of application, which included tooth and bone reconstruction, magnetic and infrared hyperthermia, chemo- and immunotherapy, the development of new drugs for targeted therapy, antibacterial and anti-inflammatory therapy, and bioimaging. In conclusion, the authors’ point of view is given about the prospects for the development of this scientific area associated with the use of native, genetically modified, or completely artificial phospholipid membranes, which allow combining the physicochemical and biological properties of biogenic prototypes with high biocompatibility, economic availability, and scalability of fully synthetic nanomaterials.

Strategies and Challenges in the Treatment of Dental Enamel

Enamel tissue, the hardest body tissue, which covers the outside of the tooth shields the living tissue, but it erodes and disintegrates in the acidic environment of the oral cavity. On the one hand, mature enamel is cell-free and, if damaged, does not regenerate. Tooth sensitivity and decay are caused by enamel loss. On the other hand, the tissue engineering approach is challenging because of the unique structure of tooth enamel. To develop an exemplary method for dental enamel rebuilding, accurate knowledge of the structure of tooth enamel, knowing how it is created and how proteins interact in its structure, is critical. Furthermore, novel techniques in tissue engineering for using stem cells to develop enamel must be established. This article aims to discuss current attempts to regenerate enamel using synthetic materials methods, recent advances in enamel tissue engineering, and the prospects of enamel biomimetics to find unique insights into future possibilities for repairing enamel tissue, perhaps the most fascinating of all tooth tissues.

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.

Effect of a new modified polyamidoamine dendrimer biomimetic system on the mineralization of type I collagen fibrils: an in vitro study

We evaluate the effects of the new Dentine matrix protein 1 (DMP-1) biomimetic system composed of phosphorylated polyamidoamine dendrimer (PAMAM-PO₃H₂) and carboxylated polyamidoamine dendrimer (PAMAM-COOH) on the mineralization of type I collagen fibrils. PAMAM-PO₃H₂ and PAMAM-COOH were observed to have the ability to induce internal and external mineralization of type I collagen fibrils in vitro through non-classical mineralization crystallization pathway, which has become a hopeful biomimetic system of biomimetic remineralization and demineralization of dentin type I collagen fibrils and has great potential in inducing biomimetic remineralization of demineralized dentin.

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.

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.

Effect of chlorhexidine-loaded poly(amido amine) dendrimer on matrix metalloproteinase activities and remineralization in etched human dentin in vitro

To investigate the effect of chlorhexidine (CHX)-loaded carboxyl-terminated poly (amido amine) dendrimer (CHX-PAMAM-COOH) on matrix metalloproteinase (MMP) activities and remineralization in human dentin, CHX-PAMAM-COOH was prepared and characterized by Fourier-transform infrared spectroscopy. The inhibitory effects of CHX, PAMAM-COOH, and CHX-PAMAM-COOH on soluble recombinant human matrix metalloproteinase (rhMMP-2) and dentin-bound endogenous MMP activity were measured using an MMP Activity Assay Kit. In situ zymography was performed to evaluate the gelatinase activity in dentin pretreated with CHX, PAMAM-COOH, and CHX-PAMAM-COOH. The remineralization of etched dentin pretreated with CHX, PAMAM-COOH, and CHX-PAMAM-COOH was evaluated by field emission-scanning electron microscopy (SEM) and energy disperse spectroscopy (EDS) after incubation in artificial saliva for 14 days. The results of the rhMMP-2 activity assay showed that the MMP-2 activity in the CHX-PAMAM-COOH group and the CHX group decreased significantly to 5.58 ± 0.85% (P < 0.05) and 4.86 ± 1.12% (P < 0.05), respectively, but that in the PAMAM-COOH group increased significantly to 213.38 ± 0.11% (P < 0.05). The results of total MMP activity and in situ zymography showed a significant reduction in endogenous gelatinase activity in dentin in the CHX-PAMAM-COOH group and the CHX group. The SEM and EDS results showed that rod-like crystals were formed on the etched dentin surface in the PAMAM-COOH group and the CHX-PAMAM-COOH group, and their Ca/P ratios were 1.73 and 1.71, respectively. In conclusion, CHX-PAMAM-COOH can inhibit dentin-bound endogenous MMPs and induce remineralization in etched dentin simultaneously. However, it is important to note that the catalytic role of PAMAM dendrimers may have an undesired excitatory effect on MMP activity, which cannot be ignored if PAMAM dendrimers were used alone in the oral environment.

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.

[Research progress on the biomimetic remineralization of hard tooth tissues based on polyamide-amine dendrimer]

Polyamide-amine (PAMAM) dendrimer, a new hyperbranched macromolecular polymer, is considered an "artificial protein" by many scholars on account of its excellent chemical and biological characteristics. PAMAM has internal cavities and a large number of reactive terminal groups. These structures allow the polymer to be used as a bionic macromoleculethat could simulate the biomimetic mineralization of the natural organic matrix on the surface of tooth tissue. Specifically, PAMAM can beused as an organic template to regulate mineral nucleation and crystal growth; thus, the polymerisa more ideal dental restoration material than traditional allogenic materials. This article reviews research progress on thePAMAM-induced biomimetic mineralization of hard tooth tissues.

The Significance and Utilisation of Biomimetic and Bioinspired Strategies in the Field of Biomedical Material Engineering: The Case of Calcium Phosphat-Protein Template Constructs

This review provides a summary of recent research on biomimetic and bioinspired strategies applied in the field of biomedical material engineering and focusing particularly on calcium phosphate-protein template constructs inspired by biomineralisation. A description of and discussion on the biomineralisation process is followed by a general summary of the application of the biomimetic and bioinspired strategies in the fields of biomedical material engineering and regenerative medicine. Particular attention is devoted to the description of individual peptides and proteins that serve as templates for the biomimetic mineralisation of calcium phosphate. Moreover, the review also presents a description of smart devices including delivery systems and constructs with specific functions. The paper concludes with a summary of and discussion on potential future developments in this field.

The inhibitory effect of carboxyl-terminated polyamidoamine dendrimers on dentine host-derived matrix metalloproteinases in vitro in an etch-and-rinse adhesive system

The biomimetic remineralization of collagen fibrils has increased interest in restoring the demineralized dentine generated by dental caries. Carboxyl-terminated polyamidoamine dendrimers (PAMAM-COOH), hyperbranched polymeric macromolecules, can act as non-collagenous proteins to induce biomimetic remineralization on a dentine organic matrix. However, in vivo remineralization is an extremely time-consuming process; before complete remineralization, demineralized dentine collagen fibrils are susceptible to degradation by host-derived matrix metalloproteinases (MMPs). Therefore, we examined the effect of fourth-generation PAMAM-COOH (G4-PAMAM-COOH) on the collagenolytic activities of endogenous MMPs, the interaction between G4-PAMAM-COOH and demineralized dentine collagen and the influence of G4-PAMAM-COOH pre-treatment on resin-dentine bonding. G4-PAMAN-COOH not only inhibited exogenous soluble rhMMP9 but also hampered the proteolytic activities of dentine collagen-bound MMPs. Cooperated with the results of G4-PAMAM-COOH absorption and desorption, FTIR spectroscopy provided evidence for the exclusive electrostatic interaction rather than hydrogen or covalent bonding between G4-PAMAM-COOH and dentine collagen. Furthermore, G4-PAMAM-COOH pre-treatment showed no damage to resin-dentine bonding because it did not significantly decrease the elastic modulus of the demineralized dentine, degree of conversion, penetration of the adhesive into the dentinal tubules or ultimate tensile strength. Thus, G4-PAMAM-COOH can effectively inactivate MMPs, retard the enzymolysis of collagen by MMPs and scarcely influence the application of resin-dentine bonding.

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.

Poly(amido amine) and rechargeable adhesive containing calcium phosphate nanoparticles for long-term dentin remineralization

OBJECTIVES

The objective of the present study was to investigate long-term dentin remineralization via the combination of poly(amido amine) (PAMAM) with a novel rechargeable adhesive containing nanoparticles of amorphous calcium phosphate (NACP).

METHODS

The NACP adhesive was immersed in lactic acid at pH 4 to exhaust its calcium (Ca) and phosphate (P) ion release, and then recharged with Ca and P ions. Dentin samples were pre-demineralized with 37% phosphoric acid, and then divided into four groups: (1) dentin control, (2) dentin treated with PAMAM, (3) dentin with recharged NACP adhesive, (4) dentin with PAMAM + recharged NACP adhesive. In group (2) and (4), the PAMAM-coated dentin was immersed in phosphate-buffered saline with vigorous shaking for 77 days to accelerate any detachment of the PAMAM macromolecules from the demineralized dentin. Samples were treated with a cyclic remineralization/demineralization regimen for 21 days.

RESULTS

After 77 days of fluid flow challenge, the immersed PAMAM still retained its nucleation template function. The recharged NACP adhesive possessed sustained ion re-release and acid-neutralization capability, both of which did not decrease with repeated recharge and re-release cycles. The immersed PAMAM with the recharged NACP adhesive achieved long-term dentin remineralization, and restored dentin hardness to that of healthy dentin.

CONCLUSIONS

The PAMAM + NACP adhesive completely remineralizes pre-demineralized dentin even after long-term fluid challenges and provides long-term remineralization to protect tooth structures.

CLINICAL SIGNIFICANCE

The novel PAMAM + NACP adhesive provides long-term bond protection and caries inhibition to increase the longevity of resin-based restorations.

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.

A positron emission tomography image-guidable unimolecular micelle nanoplatform for cancer theranostic applications

Unimolecular micelles based on hyperbranched polyamidoamine (PAMAM) dendrimer were synthesized as both a cargo delivery vector and an imaging agent for triple-negative breast tumors, and the chemical synthesis procedures are detailed in this study. With the chemical conjugation of a peptide (F3, against cellular nucleolin) to increase its cellular internalization, these micelles can accumulate potently and specifically in breast cancer cells (e.g., MDA-MB-231). The size and morphology of these PAMAM-based micelles have been measured by transmission electron microscopy (TEM) and dynamic light scattering (DLS). The hydrazone bond (responsive to pH alteration) between the loaded doxorubicin (DOX, as a model drug here) and PAMAM micelles enables cargo release following pH changes. Flow cytometry and confocal fluorescence microscopy revealed that PAMAM micelles with F3 attachment (PAMAM-DOX-F3) had stronger internalization into MDA-MB-231 cells (nucleolin-positive) than PAMAM micelles without F3 conjugation (PAMAM-DOX), whereas both of them have minimal interactions with L929 fibroblasts (nucleolin-negative). The positron-emitting isotope ⁶⁴Cu was added into PAMAM micelles by chelation to track their pharmacokinetic behavior (organ distribution profile) in vivo by positron emission tomography (PET) imaging. Serial PET imaging demonstrated that the accumulation of ⁶⁴Cu-PAMAM-DOX-F3 in MDA-MB-231 tumors was fast, potent, and persistent (tumor uptake: 6.1 ± 1.2% injection dose per gram [%ID/g] at 24 h p.i.), significantly higher than that of ⁶⁴Cu-PAMAM-DOX (2.5 ± 0.4%ID/g at the same time). Their distribution profiles in other organs/tissues were quite similar, with a relatively short circulation time. In addition, ex vivo fluorescence imaging confirmed that DOX can be delivered efficiently by these PAMAM micelles to MDA-MB-231 tumors. Deducing from these data, we believe that PAMAM-based micelles can be useful for selective combinational treatment of cancer.

STATEMENT OF SIGNIFICANCE

Micelles are a very useful biomaterial for theranostic purposes, and one of the major hurdles for micelles (particularly those from self-assembling) is their relatively low stability, especially when administered in vivo. In this study, we have attempted to overcome this limitation by designing unimolecular micelles (based on the concept of "one micelle is composed of one macromolecule") from polyamidoamine (PAMAM) dendrimers, in which the drug cargos (e.g., doxorubicin) are chemically attached to PAMAM through a hydrazone bond; hence, they can be used as a tumor-selective diagnostic/therapeutic platform. These unimolecular micelles possess superior stability compared to conventional micelles and can undertake stimulus (pH)-responsive cargo release for more "targeted" cancer therapy. With the incorporation of a tumor-targeting peptide sequence (F3) and a positron-emitting isotope (copper-64), the pharmacokinetic behavior of these micelles can be readily monitored by positron emission tomography imaging technique to confirm their specificity against cancer tissues. With further optimization, this micellar platform can have a broad clinical applicability owing to its biocompatibility, selectivity, and stability.

Hierarchical Biomineralization: from Nature's Designs to Synthetic Materials for Regenerative Medicine and Dentistry

Biomineralization is a highly dynamic, yet controlled, process that many living creatures employ to develop functional tissues such as tooth enamel, bone, and others. A major goal in materials science is to create bioinspired functional structures based on the precise organization of building blocks across multiple length scales. Therefore, learning how nature has evolved to use biomineralization could inspire new ways to design and develop synthetic hierarchical materials with enhanced functionality. Toward this goal, this review dissects the current understanding of structure-function relationships of dental enamel and bone using a materials science perspective and discusses a wide range of synthetic technologies that aim to recreate their hierarchical organization and functionality. Insights into how these strategies could be applied for regenerative medicine and dentistry are also provided.

Exogenous mineralization of hard tissues using photo-absorptive minerals and femto-second lasers; the case of dental enamel

A radical new methodology for the exogenous mineralization of hard tissues is demonstrated in the context of laser-biomaterials interaction. The proposed approach is based on the use of femtosecond pulsed lasers (fs) and Fe³⁺-doped calcium phosphate minerals (specifically in this work fluorapatite powder containing Fe₂O₃ nanoparticles (NP)). A layer of the synthetic powder is applied to the surface of eroded bovine enamel and is irradiated with a fs laser (1040 nm wavelength, 1 GHz repetition rate, 150 fs pulse duration and 0.4 W average power). The Fe₂O₃ NPs absorb the light and may act as thermal antennae, dissipating energy to the vicinal mineral phase. Such a photothermal process triggers the sintering and densification of the surrounding calcium phosphate crystals thereby forming a new, dense layer of typically ∼20 μm in thickness, which is bonded to the underlying surface of the natural enamel. The dispersed iron oxide NPs, ensure the localization of temperature excursion, minimizing collateral thermal damage to the surrounding natural tissue during laser irradiation. Simulated brushing trials (pH cycle and mechanical force) on the synthetic layer show that the sintered material is more acid resistant than the natural mineral of enamel. Furthermore, nano-indentation confirms that the hardness and Young's modulus of the new layers are significantly more closely matched to enamel than current restorative materials used in clinical dentistry. Although the results presented herein are exemplified in the context of bovine enamel restoration, the methodology may be more widely applicable to human enamel and other hard-tissue regenerative engineering.

STATEMENT OF SIGNIFICANCE

In this work we provide a new methodology for the mineralisation of dental hard tissues using femtosecond lasers and iron doped biomaterials. In particular, we demonstrate selective laser sintering of an iron doped fluorapatite on the surface of eroded enamel under low average power and mid-IR wavelength and the formation of a new layer to substitute the removed material. The new layer is evaluated through simulated brushing trials and nano-indentation. From the results we can conclude that is more acid resistant than natural enamel while, its mechanical properties are superior to that of current restorative materials. To the best of our knowledge this is the first time that someone demonstrated, laser sintering and bonding of calcium phosphate biomaterials on hard tissues. Although we here we discuss the case of dental enamel, similar approach can be adopted for other hard tissues, leading to new strategies for the fixation of bone/tooth defects.

Poly (amido amine) dendrimer and dental adhesive with calcium phosphate nanoparticles remineralized dentin in lactic acid

Patients with dry mouth often have an acidic oral environment lacking saliva to provide calcium (Ca) and phosphate (P) ions. There has been no report on tooth remineralization in acidic pH4 and CaP ion-lacking solutions. The objective of this study was to develop a novel method of combining poly(amido amine) (PAMAM) with adhesive containing nanoparticles of amorphous calcium phosphate (NACP) for dentin remineralization in pH4 and CaP-lacking solution for the first time. Demineralized dentin was tested in four groups: (1) dentin control, (2) dentin with PAMAM, (3) dentin with NACP adhesive, (4) dentin with PAMAM + NACP adhesive. Dentin samples were examined by scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS) and hardness testing. Increasing the NACP filler level in adhesive from 0 to 40 wt% did not negatively affect the dentin bond strength (p > 0.1). NACP adhesive released CaP ions and neutralized the acid. PAMAM alone failed to achieve dentin remineralization in lactic acid. NACP alone induced slight dentin remineralization in lactic acid (p > 0.1). In contrast, the novel PAMAM + NACP group in the pH4 and CaP-lacking solution completely remineralized the predemineralized dentin, increasing its hardness which approached that of healthy dentin (p > 0.1). In conclusion, dentin remineralization via PAMAM + NACP adhesive in pH4 and CaP-lacking acid was achieved for the first time, when conventional remineralization methods such as PAMAM or NACP did not work. The novel PAMAM + NACP method is promising to increase the longevity of the composite-tooth bond, inhibit caries, remineralize lesions and protect tooth structures, even for patients with dry mouth and an acidic oral environment. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2414-2424, 2018.

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.

Effect and Stability of Poly(Amido Amine)-Induced Biomineralization on Dentinal Tubule Occlusion

In recent years, scientists have developed various biomaterials to remineralize human teeth to treat dentine hypersensitivity. Poly(amido amine) (PAMAM) dendrimers have become a research focus in this field. It has been demonstrated that PAMAM is able to create precipitates both on the surface of and within the dentinal tubules, however, there is little information about its effect on reducing dentine permeability in vitro. This study aimed to evaluate the in vitro effectiveness and stability of the fourth generation amine-terminated PAMAM on dentinal tubule occlusion, especially on dentine permeability. Sodium fluoride (NaF), which has been widely used as a desensitizing agent, is regarded as positive control. Demineralized sensitive dentine samples were coated with PAMAM or sodium fluoride solutions and soaked in artificial saliva (AS) at 37 °C for different periods. Four weeks later, samples in each group were then equally split into two subgroups for testing using a brushing challenge and an acid challenge. Dentine permeability of each specimen was measured before and after each challenge using a fluid filtration system. Dentine morphology and surface deposits were characterized by scanning electron microscope (SEM) and analyzed with Image-Pro Plus software. Data were evaluated through multifactorial ANOVA with repeated measures and pair-wise comparisons at a level of 5%. The results showed that PAMAM and NaF significantly reduced dentine permeability to 25.1% and 20.7%. Both of them created precipitates on dentine surfaces after AS immersion for 28 days. PAMAM-induced biomineralization not only on dentine surfaces, but also deeper in dentinal tubules, significantly reduced dentine permeability. Moreover, PAMAM-induced biomineralization elicited excellent stable occlusion effects after acid challenge. In conclusion, PAMAM demonstrated a strong ability to resist acid and showed great potential to be used in the treatment of dentine hypersensitivity in future.

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.

Advances in polymeric materials for dental applications

This review focuses on the relationship between the structures and properties of various polymers for different applications in dentistry.

Poly (amido amine) and nano-calcium phosphate bonding agent to remineralize tooth dentin in cyclic artificial saliva/lactic acid

The objectives of this study were to develop a novel method to remineralize dentin lesions, and investigate the remineralization effects of poly (amido amine) (PAMAM) dendrimer plus a bonding agent with nanoparticles of amorphous calcium phosphate (NACP) in a cyclic artificial saliva/lactic acid environment for the first time. Dentin lesions were produced via phosphoric acid. Four groups were tested: (1) dentin control, (2) dentin with PAMAM, (3) dentin with NACP bonding agent, and (4) dentin with PAMAM plus NACP bonding agent. Specimens were treated with cyclic artificial saliva/lactic acid. The remineralized dentin was examined using scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), hardness and attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR). NACP bonding agent yielded a dentin shear bond strength similar to commercial controls (Prime & Bond NT, Dentsply; Scotchbond Multi-purpose, 3M) (p>0.1). Increasing NACP in bonding agent from 0 to 40% did not affect bond strength. NACP bonding agent neutralized the acid and released Ca ions with concentrations of 4 to 20mmol/L, and P ions of 2 to 9mmol/L. PAMAM or NACP bonding agent alone achieved slight remineralization. The PAMAM+NACP group achieved the greatest dentin remineralization p<0.05). At 20days, PAMAM+NACP increased the hardness of pre-demineralized dentin to reach the normal dentin hardness (p>0.1). In conclusion, superior remineralization of PAMAM+NACP bonding agent was demonstrated for the first time. PAMAM+NACP bonding agent induced dentin remineralization under acid challenge, when conventional remineralization methods such as PAMAM alone did not work well. The novel PAMAM+NACP bonding agent method is promising to improve the longevity of resin-dentin bonds, inhibit caries, and protect teeth.

Functional dendritic compounds: potential prospective candidates for dental restorative materials and in situ re-mineralization of human tooth enamel

This review provides a snapshot of recent progress in the synthesis and application of dendritic compounds as potential prospective candidates for dental restorative materials andin siture-mineralization of human tooth enamel.

Advances in Dental Materials through Nanotechnology: Facts, Perspectives and Toxicological Aspects

Nanotechnology is currently driving the dental materials industry to substantial growth, thus reflecting on improvements in materials available for oral prevention and treatment. The present review discusses new developments in nanotechnology applied to dentistry, focusing on the use of nanomaterials for improving the quality of oral care, the perspectives of research in this arena, and discussions on safety concerns regarding the use of dental nanomaterials. Details are provided on the cutting-edge properties (morphological, antibacterial, mechanical, fluorescence, antitumoral, and remineralization and regeneration potential) of polymeric, metallic and inorganic nano-based materials, as well as their use as nanocluster fillers, in nanocomposites, mouthwashes, medicines, and biomimetic dental materials. Nanotoxicological aspects, clinical applications, and perspectives for these nanomaterials are also discussed.

Biomimetic mineralization of collagen fibrils induced by amine-terminated PAMAM dendrimers--PAMAM dendrimers for remineralization

OBJECTIVE

Achieving biomimetic mineralization of collagen fibrils by mimicking the role of non-collagenous proteins (NCPs) with biomimetic analogs is of great interest in the fields of material science and stomatology. Amine-terminated PAMAM dendrimer (PAMAM-NH2), which possesses a highly ordered architecture and many calcium coordination sites, may be a desirable template for simulating NCPs to induce mineralization of collagen fibrils. In this study, we focused on the ability of PAMAM-NH2 to mineralize collagen fibrils.

DESIGN

Type-I collagen fibrils were reconstituted over 400-mesh formvar-and-carbon-coated gold grids and treated with a third-generation PAMAM-NH2 (G3-PAMAM-NH2) solution. The treated collagen fibrils were immersed in artificial saliva for different lengths of time. The morphologies of the mineralized reconstituted type-I collagen fibrils were characterized by transmission electron microscopy.

RESULTS

No obvious mineralized collagen fibrils were detected in the control group. On the contrary, collagen fibrils were heavily mineralized in the experimental group. Most importantly, intrafibrillar mineralization was achieved within the reconstituted type-I collagen fibrils.

CONCLUSIONS

In this study, we successfully induced biomimetic mineralization within type-I collagen fibrils using G3-PAMAM-NH2. This strategy may serve as a potential therapeutic technique for restoring completely demineralized collagenous mineralized tissues.

Study on the influence of leucine-rich amelogenin peptide (LRAP) on the remineralization of enamel defects via micro-focus x-ray computed tomography and nanoindentation

Regeneration of severely damaged enamel (e.g. deep demineralized lesions) is currently not possible, because the structural units of enamel crystal construction are removed after its maturation. The aim of this in vitro study was to evaluate the effect of surface impregnation by leucine-rich amelogenin peptide (LRAP) on the remineralization of eroded enamel using micro-focus x-ray computed tomography (µCT). Fifteen bovine enamel blocks were embedded in resin and three zones (sound, demineralization, and remineralization) were defined on each specimen. Lesions were prepared by immersing the samples in demineralization solution for 7 d. The samples were soaked in distilled water or 60 or 120 µg mL(-1) solution of LRAP in water for 30 min. After the surface treatment, specimens were incubated in artificial saliva for either 5 or 10 d at 37 °C. The amount of mineral gain (dΔZ%) and the relative changes in the lesion depth (dLD%), obtained from µCT, were used to evaluate the effect of LRAP on the remineralization of lesions. The effects of LRAP on cross-sectional integrated hardness ΔINH were studied after 10 d using nanoindentation. ANOVA test was used to determine the effect of time and/or LRAP concentration on dΔZ%, dLD% and ΔINH mean values. Tukey's analysis was used for multiple comparison testing (α = 0.05). Analysis of µCT data showed significant effect of time and LRAP concentration on the dΔZ% (p = 0.013, p = 0.003) and the dLD% (p  <  0.001, p = 0.002) mean values. The nanoindentation hardness was significantly improved by 120 µg mL(-1) LRAP (p = 0.02). Also, the peptide treatment affected the mineral distribution throughout the lesion by inhibiting of superficial deposition. This study showed that the treatment of eroded lesions in enamel by LRAP can improve and regulate the pattern of remineralization in vitro.

Methods for Biomimetic Mineralisation of Human Enamel: A Systematic Review

Biomimetic mineralisation is an alternative restorative methodology that imitates the natural process of mineralisation. We aimed to systematically review the laboratory methods on the biomimetic mineralisation of demineralised enamel. A search in the PubMed, ScienceDirect, and ISI Web of Science databases was performed. Clinical trials, reviews, non-English articles, animal teeth, non-tooth substrates, and irrelevant studies were excluded. After screening the titles and abstracts of initially searched articles, 20 papers remained for full-text analysis. Eight articles were identified from the references of the remaining papers. A total of 28 studies were included in this systematic review. We found that protein or protein analogues were used to mimic the function of natural protein in 23 studies. Bioactive components inspired by mussel, an agarose hydrogel model, a glycerine-enriched gelatine technique, and ethylenediaminetetraacetic acid, were also used for biomimetic mineralisation of enamel. These laboratory studies reported success in the biomimetic mineralisation of enamel. Potential further research on the biomimetic mineralisation of enamel was discussed.

Leucine-rich amelogenin peptide (LRAP) as a surface primer for biomimetic remineralization of superficial enamel defects: An in vitro study

This study was carried out to obtain more information about the assembly of hydroxyapatite bundles formed in the presence of Leucine-Rich Amelogenin Peptide (LRAP) and to evaluate its effect on the remineralization of enamel defects through a biomimetic approach. One or 2 mg/mL LRAP solutions containing 2.5 mM of Ca(+2) and 1.5 mM phosphate were prepared (pH = 7.2) and stored at 37 °C for 24 h. The products of the reaction were studied using atomic force microscopy (AFM), transmission electron microscopy (TEM), and selected area electron diffraction (SAED). Vickers surface microhardness recovery (SMR%) of acid-etched bovine enamel, with or without LRAP surface treatment, were calculated to evaluate the influence of peptide on the lesion remineralization. Distilled water and 1 or 2 mg/mL LRAP solution (pH = 7.2) were applied on the lesions and the specimens were incubated in mineralization solution (2.5mM Ca(+2) , 1.5mM PO4 (-3) , pH = 7.2) for 24 h. One-way ANOVA and Tukey's multi-comparison tests were used for statistical analysis. The pattern of enamel surface repair was studied using FE-SEM. AFM showed the formation of highly organized hierarchical structures, composed of hydroxyapatite (HA) crystals, similar to the dental enamel microstructure. ANOVA procedure showed significant effect of peptide treatment on the calculated SMR% (p < 0.001). Tukey's test revealed that peptide treated groups had significantly higher values of SMR%. In conclusion, LRAP is able to regulate the formation of HA and enhances the remineralization of acid-etched enamel as a surface treatment agent.

Biomimetic Remineralization of Human Enamel in the Presence of Polyamidoamine Dendrimers in vitro

Poly(amidoamine) (PAMAM) dendrimers, known as artificial proteins, have unique and well-defined molecular size and structure. It has previously been used to mimic protein-crystal interaction during biomineralization. In this study, generation 4.5 (4.5G) PAMAM with carboxylic acid (PAMAM-COOH) was synthesized and utilized to remineralize the surface of etched enamel in vitro. Using confocal laser scanning microscopy, Fourier transform infrared spectroscopy, X-ray diffraction analysis and scanning electron microscopy we observed that 4.5G PAMAM-COOH can be absorbed on the etched enamel surface and that it can induce the formation of hydroxyapatite crystals with the same orientation as that of the enamel prisms on longitudinal and transversal enamel surfaces. The self-assembly behavior of PAMAM in the mineralization solution was also investigated and the result showed that 4.5G PAMAM can assemble to microribbon structure similar to the behavior of amelogenins. Therefore, we concluded that 4.5G PAMAM-COOH assemblies can act as the organic template on enamel surface and in mineralization solution to control the nucleation site and morphology of new-grown crystals to form the biomimetic structure of human enamel, which may open a new way for repairing damaged enamel.

Noninvasive Dentistry: A Dream or Reality?

Various caries prevention and repair strategies are reviewed in this article ranging from the use of fluoride to nanohydroxyapatite particles. Several of the strategies which combine fluoride and calcium and phosphate treatments have both in vitro and in vivo data showing them to be efficacious if the surface integrity of the lesion is not breached. Once this has occurred, the rationale for cutting off the nutrient supplies to the pathogenic bacteria without the removal of the infected dentine, a noninvasive restorative technique, is discussed using existing clinical studies as examples. Finally two novel noninvasive restorative techniques using fluorohydroxyapatite crystals are described. The need for clinical data in support of emerging caries-preventive and restorative strategies is emphasized.

Recent developments and applications of bioinspired dendritic polymers

This review highlights the bioinspired applications of dendritic polymers, focusing on their structure–function relationship to natural biomolecules such as proteins.

Poly(ethylene oxide)-based block copolymers with very high molecular weights for biomimetic calcium phosphate mineralization

Ampholytic and betaine-type block copolymers are excellent growth modifiers for calcium phosphate in biologically inspired calcium phosphate mineralization.

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

In the bioinspired repair process of tooth enamel, it is important to simultaneously mimic the organic-matrix-induced biomineralization and increase the binding strength at the remineralization interface. In this work, a fourth-generation polyamidoamine dendrimer (PAMAM) is modified by dimethyl phosphate to obtain phosphate-terminated dendrimer (PAMAM-PO3H2) since it has a similar dimensional scale and peripheral functionalities to that of amelogenin, which plays important role in the natural development process of enamel. Its phosphate group has stronger affinity for calcium ion than carboxyl group and can simultaneously provide strong hydroxyapatite (HA)-binding capability. The MTT assay demonstrates the low cytotoxicity of PAMAM-PO3H2. Adsorption tests indicate that PAMAM-PO3H2 can be tightly adsorbed on the human tooth enamel. Scanning electron microscopy and X-ray diffraction are used to analyze the remineralization process. After being incubated in artificial saliva for 3weeks, there is a newly generated HA layer of 11.23μm thickness on the acid-etched tooth enamel treated by PAMAM-PO3H2, while the thickness for the carboxyl-terminated one (PAMAM-COOH) is only 6.02μm. PAMAM-PO3H2 can regulate the remineralization process to form ordered new crystals oriented along the Z-axis and produce an enamel prism-like structure that is similar to that of natural tooth enamel. The animal experiment also demonstrates that PAMAM-PO3H2 can induce significant HA regeneration in the oral cavity of rats. Thus PAMAM-PO3H2 shows great potential as a biomimetic restorative material for human tooth enamel.

Enamel regeneration - current progress and challenges

Dental Enamel is the outermost covering of teeth. It is hardest mineralized tissue present in the human body. Enamel faces the challenge of maintaining its integrity in a constant demineralization and remineralization within the oral environment and it is vulnerable to wear, damage, and decay. It cannot regenerate itself, because it is formed by a layer of cells that are lost after the tooth eruption. Conventional treatment relies on synthetic materials to restore lost enamel that cannot mimic natural enamel. With advances in material science and understanding of basic principles of organic matrix mediated mineralization paves a way for formation of synthetic enamel. The knowledge of enamel formation and understanding of protein interactions and their gene products function along with the isolation of postnatal stem cells from various sources in the oral cavity, and the development of smart materials for cell and growth factor delivery, makes possibility for biological based enamel regeneration. This article will review the recent endeavor on biomimetic synthesis and cell based strategies for enamel regeneration.