Remineralization and repair of enamel surface by biomimetic Zn-carbonate hydroxyapatite containing toothpaste: a comparative in vivo study

Marco Lelli, Angelo Putignano, Marco Marchetti, Ismaela Foltran, Francesco Mangani, Maurizio Procaccini, Norberto Roveri, Giovanna Orsini, Marco Lelli, Angelo Putignano, Marco Marchetti, Ismaela Foltran, Francesco Mangani, Maurizio Procaccini, Norberto Roveri, Giovanna Orsini

Abstract

Consumption of acidic foods and drinks and other factors that cause enamel wear are responsible for the daily enamel loss and degradation. Use of some toothpastes that have been showed to possess different properties of remineralisation and/or repair of the enamel surface may help to protect tooth enamel. The aim of this study was to evaluate whether the use of toothpaste containing Zn-carbonate hydroxyapatite (CHA) nanostructured microcrystals may exert remineralization/repair effects of the enamel surface. Two groups of patients, aged between 18 and 75 years, used a Zn-CHA nanocrystals-based toothpaste (experimental group) and a potassium nitrate/sodium fluoride toothpaste (active control group) for 8 weeks. At the end of this period, extractions were performed in five subjects per study group. Negative controls consisted of two subjects treated with non-specified fluoride toothpaste. Teeth were processed for morphological and chemical-physic superficial characterizations by means of Scanning Electronic Microscopy with Elementary analysis, X-Ray Diffraction analysis and Infrared analysis. In this study, the use of a Zn-CHA nanocrystals toothpaste led to a remineralization/repair of the enamel surface, by deposition of a hydroxyapatite-rich coating. On the other hand, the use of both a nitrate potassium/sodium fluoride and non-specified fluoride toothpastes did not appreciably change the enamel surface. In conclusion, this study demonstrates that the toothpaste containing Zn-CHA nanostructured microcrystals, differently from nitrate potassium/sodium fluoride and non-specified fluoride toothpastes, may promote enamel superficial repair by means of the formation of a protective biomimetic CHA coating.

Keywords: Zn-carbonate hydroxyapatite nanocrystals; enamel; fluoride; remineralization; repair; toothpaste.

Figures

Figure 1
Figure 1
Scanning electron micrograph of synthetic biomimetic CHA nanocrystals forming microclasters (A), and the inset showing the transmission electron micrograph of CHA nanocrystals with characteristic acicular morphology (B).
Figure 2
Figure 2
X-ray diffraction patterns collected for synthetic biomimetic CHA nanocrystals (A), CHA nanostructured microcrystals (B), and human tooth enamel (C).
Figure 3
Figure 3
FT-IR Synthetic biomimetic CHA nanostructured microclusters (A), and natural enamel (B).
Figure 4
Figure 4
Scanning electron micrograph of the enamel surface of a tooth in vivo treated using the Zn-CHA toothpaste (A), EDAX results using a probe pointed in the area labeled by the white circle (B), EDAX results using a probe pointed in the area labeled by the black circle (C).
Figure 5
Figure 5
Scanning electron micrograph of the enamel surface of a tooth in vivo treated using the KNO3/NaF toothpaste (A), EDAX with probe pointed in the area labeled by the white circle (B), EDAX with probe pointed in the area labeled by the black circle (C).
Figure 6
Figure 6
Scanning electron micrograph of the enamel surface treated using a non-specified fluoride toothpaste, showing a zone of enamel loss (arrow).
Figure 7
Figure 7
DRX pattern of the enamel after the in vivo treatment using the following. (A) synthetic biomimetic CHA nanostructured microclusters, (B) Zn-CHA toothpaste, (C) KNO3/NaF toothpaste, (D) Fluoride toothpaste.
Figure 8
Figure 8
FT-IR of the enamel surface after treatment using. (A) Zn-CHA containing toothpaste, (B) KNO3/NaF toothpaste, (C) Fluoride toothpaste.

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