Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-Analysis
The objective of this article was to systematically provide an up-to-date review on the different methods of remineralizing human dentine using different biomimetic agents. The authors performed a systematic search within PubMed, Scopus, and Web of Science in addition to the grey literature in Googl...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
|
| Series: | Biomimetics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2313-7673/8/2/159 |
| _version_ | 1797595973625577472 |
|---|---|
| author | Ali Azhar Dawasaz Rafi Ahmad Togoo Zuliani Mahmood Azlina Ahmad Kannan Thirumulu Ponnuraj |
| author_facet | Ali Azhar Dawasaz Rafi Ahmad Togoo Zuliani Mahmood Azlina Ahmad Kannan Thirumulu Ponnuraj |
| author_sort | Ali Azhar Dawasaz |
| collection | DOAJ |
| description | The objective of this article was to systematically provide an up-to-date review on the different methods of remineralizing human dentine using different biomimetic agents. The authors performed a systematic search within PubMed, Scopus, and Web of Science in addition to the grey literature in Google Scholar<sup>®</sup> using MeSH terms. The PICO question was P: human teeth dentinal sections; I: application of biomimetic remineralizing agents; C: other non-biomimetic approaches; O: extent of remineralization and physical properties of remineralized dentine. The initially identified studies were screened for titles and abstracts. Non-English articles, reviews, animal studies, studies involving the resin–dentine interface, and other irrelevant articles were then excluded. The other remaining full-text articles were retrieved. Bibliographies of the remaining articles were searched for relevant studies that could be included. A total of 4741 articles were found, and finally, 39 full-text articles were incorporated in the current systematic review. From these, twenty-six research studies used non-collagenous protein (NCP) analogs to biomineralize dentine, six studies used bioactive materials derived from natural sources, six studies used zinc hydroxyapatite, and one study used amelogenin peptide to induce hydroxyapatite formation on the surface of demineralized dentine. Additive effects of triclosan and epigenin were assessed when combined with commonly available NCPs. Overall, a moderate risk of bias was observed and, hence, the findings of the included studies could be acceptable. A meta-analysis of some similar studies was performed to assess the depth of remineralization and elastic modulus. Despite having high heterogeneity (I<sup>2</sup> > 90), all the studies showed a significant improvement in biomimetic remineralization efficacy as compared to the control. All the included studies carried out a functional remineralization assessment and found a 90–98% efficacy in the extent of remineralization while the elastic modulus reached 88.78 ± 8.35 GPa, which is close to natural dentine. It is pertinent to note the limitations of these studies that have been carried out in vitro under controlled settings, which lack the effects of a natural oral environment. To conclude, the authors suggest that the biomimetic remineralization of dentine using NCP analogs, bioactive materials, and natural products carries significant potential in treating dentinal lesions; however, more long-term studies are needed to assess their clinical applications in vivo. |
| first_indexed | 2024-03-11T02:43:58Z |
| format | Article |
| id | doaj.art-9a43a60913d14fe39a774c57ff008d68 |
| institution | Directory Open Access Journal |
| issn | 2313-7673 |
| language | English |
| last_indexed | 2024-03-11T02:43:58Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomimetics |
| spelling | doaj.art-9a43a60913d14fe39a774c57ff008d682023-11-18T09:28:33ZengMDPI AGBiomimetics2313-76732023-04-018215910.3390/biomimetics8020159Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-AnalysisAli Azhar Dawasaz0Rafi Ahmad Togoo1Zuliani Mahmood2Azlina Ahmad3Kannan Thirumulu Ponnuraj4Department of Diagnostic Dental Sciences, College of Dentistry, King Khalid University, Abha 62529, Saudi ArabiaDepartment of Pediatric Dentistry and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha 62529, Saudi ArabiaSchool of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, MalaysiaSchool of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, MalaysiaSchool of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, MalaysiaThe objective of this article was to systematically provide an up-to-date review on the different methods of remineralizing human dentine using different biomimetic agents. The authors performed a systematic search within PubMed, Scopus, and Web of Science in addition to the grey literature in Google Scholar<sup>®</sup> using MeSH terms. The PICO question was P: human teeth dentinal sections; I: application of biomimetic remineralizing agents; C: other non-biomimetic approaches; O: extent of remineralization and physical properties of remineralized dentine. The initially identified studies were screened for titles and abstracts. Non-English articles, reviews, animal studies, studies involving the resin–dentine interface, and other irrelevant articles were then excluded. The other remaining full-text articles were retrieved. Bibliographies of the remaining articles were searched for relevant studies that could be included. A total of 4741 articles were found, and finally, 39 full-text articles were incorporated in the current systematic review. From these, twenty-six research studies used non-collagenous protein (NCP) analogs to biomineralize dentine, six studies used bioactive materials derived from natural sources, six studies used zinc hydroxyapatite, and one study used amelogenin peptide to induce hydroxyapatite formation on the surface of demineralized dentine. Additive effects of triclosan and epigenin were assessed when combined with commonly available NCPs. Overall, a moderate risk of bias was observed and, hence, the findings of the included studies could be acceptable. A meta-analysis of some similar studies was performed to assess the depth of remineralization and elastic modulus. Despite having high heterogeneity (I<sup>2</sup> > 90), all the studies showed a significant improvement in biomimetic remineralization efficacy as compared to the control. All the included studies carried out a functional remineralization assessment and found a 90–98% efficacy in the extent of remineralization while the elastic modulus reached 88.78 ± 8.35 GPa, which is close to natural dentine. It is pertinent to note the limitations of these studies that have been carried out in vitro under controlled settings, which lack the effects of a natural oral environment. To conclude, the authors suggest that the biomimetic remineralization of dentine using NCP analogs, bioactive materials, and natural products carries significant potential in treating dentinal lesions; however, more long-term studies are needed to assess their clinical applications in vivo.https://www.mdpi.com/2313-7673/8/2/159tooth remineralizationdentinebiomimeticspolyacrylic acidsodium trimetaphosphate |
| spellingShingle | Ali Azhar Dawasaz Rafi Ahmad Togoo Zuliani Mahmood Azlina Ahmad Kannan Thirumulu Ponnuraj Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-Analysis Biomimetics tooth remineralization dentine biomimetics polyacrylic acid sodium trimetaphosphate |
| title | Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-Analysis |
| title_full | Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-Analysis |
| title_fullStr | Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-Analysis |
| title_short | Remineralization of Dentinal Lesions Using Biomimetic Agents: A Systematic Review and Meta-Analysis |
| title_sort | remineralization of dentinal lesions using biomimetic agents a systematic review and meta analysis |
| topic | tooth remineralization dentine biomimetics polyacrylic acid sodium trimetaphosphate |
| url | https://www.mdpi.com/2313-7673/8/2/159 |
| work_keys_str_mv | AT aliazhardawasaz remineralizationofdentinallesionsusingbiomimeticagentsasystematicreviewandmetaanalysis AT rafiahmadtogoo remineralizationofdentinallesionsusingbiomimeticagentsasystematicreviewandmetaanalysis AT zulianimahmood remineralizationofdentinallesionsusingbiomimeticagentsasystematicreviewandmetaanalysis AT azlinaahmad remineralizationofdentinallesionsusingbiomimeticagentsasystematicreviewandmetaanalysis AT kannanthirumuluponnuraj remineralizationofdentinallesionsusingbiomimeticagentsasystematicreviewandmetaanalysis |