Scientific Article Review:

Enamel Remineralization and Repair Results of Biomimetic Hydroxyapatite Toothpaste on Deciduous Teeth

Published In: Journal of Nanobiotechnology
Publication Year: 2019

Study Design

This research employed both in vitro and in vivo methodologies to evaluate the effectiveness of biomimetic hydroxyapatite toothpaste compared to fluoride toothpastes in promoting enamel remineralization and repair.

Funding Sources

The study did not report specific funding sources or disclose conflicts of interest.

PICO Framework - what was studied and how?

• Population:
  Children aged 7–10 years with extracted deciduous first molars.

• Intervention:
  Use of biomimetic hydroxyapatite toothpaste.

• Comparison:
  Toothpastes containing fluoride at concentrations of 500 ppm and 1400 ppm, as well as a non-active control toothpaste.

• Outcomes:

  • Enamel remineralization and surface smoothness assessed via roughness analysis and scanning electron microscopy (SEM).
  • Antibacterial activity against Streptococcus mutans.
  • Inhibition of biofilm formation.

In Paragraph Form:
This study evaluated the effects of biomimetic hydroxyapatite toothpaste on the remineralization and repair of enamel in children aged 7–10 years. It compared these effects with toothpastes containing fluoride (500 ppm and 1400 ppm) and a non-active control. The outcomes measured included enamel smoothness, antibacterial efficacy against Streptococcus mutans, and biofilm inhibition.

Inclusion and Exclusion Criteria

• Inclusion Criteria:

  • Extracted deciduous molars due to orthodontic reasons or natural exfoliation.
  • Teeth without visible structural damage or cracks.

• Exclusion Criteria:

  • Teeth with severe enamel damage or structural deformities.

Study Demographics and Cohorts

• Total Sample: 30 extracted deciduous molars.
• Groups:
  • Biomimetic hydroxyapatite toothpaste group.
  • Fluoride toothpaste groups (500 ppm and 1400 ppm).
  • Non-active control toothpaste group.

Primary Outcome Variables and Results

Enamel Surface Roughness (Root Mean Square Deviation, Rq)

• Biomimetic Hydroxyapatite: Rq = 123.44 ± 20.56
• Fluoride (1400 ppm): Rq = 144.43 ± 16.83
• Fluoride (500 ppm): Rq = 163.85 ± 15.72
• Control: Rq = 175.18 ± 8.95

Key Findings:

• Biomimetic toothpaste significantly outperformed both fluoride groups in reducing enamel roughness (p < 0.05).
• No significant difference was observed between 500 ppm fluoride and the non-active control toothpaste (p > 0.05).

Antibacterial Activity

• Both biomimetic hydroxyapatite and fluoride-based toothpastes exhibited similar antibacterial efficacy against Streptococcus mutans and biofilm formation.

Simple Chart: Enamel Roughness Reduction

Study Conclusions

The study concluded that biomimetic hydroxyapatite toothpaste effectively remineralizes enamel, creating smoother surfaces compared to fluoride toothpastes. It provides similar antibacterial properties without the risk of dental fluorosis, making it a safer option for children under six.

Discussion: Strengths and Limitations

Strengths:

• Use of advanced SEM imaging provided detailed insights into enamel repair.
• Included statistical validation of results.
• Addressed public health concerns regarding fluoride overexposure in children.

Limitations:

• Limited sample size (30 teeth).
• Short duration of intervention (15 days).
• Results may differ with long-term use and other oral hygiene practices.

Citation

Bossù M, et al. Enamel remineralization and repair results of biomimetic hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste. J Nanobiotechnol. 2019;17:17. Link to article