Scientific Article Review:

Nano-hydroxyapatite and Its Applications in Preventive, Restorative, and Regenerative Dentistry

Published In: Annali di Stomatologia
Publication Year: 2014

Study Design

This article is a review of the literature summarizing findings from various experimental studies and clinical trials on the use of nano-hydroxyapatite (nano-HA) in dentistry.

Funding Sources

The article does not explicitly mention funding sources or conflicts of interest.

PICO Framework - what was studied and how?

Population

• Patients with dental concerns including enamel demineralization, dentin hypersensitivity, or periodontal issues.

Intervention

• Use of nano-hydroxyapatite in toothpaste, bone grafts, or coatings for dental implants.

Comparison

• Conventional fluoride treatments or untreated controls.

Outcomes

• Enhanced remineralization, reduced hypersensitivity, improved mechanical properties of dental materials, and better osteointegration in implants.

In Paragraph Form:
The review examines the effects of nano-hydroxyapatite compared to conventional fluoride treatments and untreated controls across various dental applications, including enamel remineralization, dentin hypersensitivity reduction, and implant integration. Outcomes include improved enamel and dentin repair, enhanced mechanical properties of restorative materials, and increased bone-to-implant contact.

Inclusion and Exclusion Criteria

Inclusion Criteria:

• Studies involving the use of nano-hydroxyapatite in dental treatments.

Exclusion Criteria:

• Articles focusing exclusively on other biomaterials without comparative analysis to nano-HA.

Demographics and Study Design

The review aggregates data from multiple studies, with experimental setups including bovine enamel and human clinical trials. Sample sizes vary widely, such as:

• 70 enamel and dentin blocks in an in-vitro remineralization study.
• 85 individuals in a randomized clinical trial on dentin hypersensitivity.
• 78 rats for an implant integration study.

Primary Outcome Variables and Results

1. Remineralization of Enamel and Dentin:

   • Nano-HA showed superior remineralization compared to fluoride.
   • Improved enamel microhardness after remineralization with nano-HA (p < 0.05).

2. Dentin Hypersensitivity Reduction:

   • Rapid desensitization observed with nano-HA-containing toothpaste.
   • Hypersensitivity scores decreased by >30% in 3 days.

3. Enhanced Mechanical Properties of Restorative Materials:

   • Nano-HA improved compressive strength (177–179 MPa vs. 160 MPa, p < 0.05) in glass ionomer cements.

4. Implant Integration:

   • Nano-HA-coated implants showed increased bone-to-implant contact and inhibited soft tissue infiltration near implants.

Conclusions

Nano-hydroxyapatite demonstrates remarkable efficacy across various dental applications. It provides superior enamel remineralization compared to fluoride, effectively reduces dentin hypersensitivity, enhances restorative material properties, and improves osteointegration for implants. These properties position nano-HA as a versatile and promising material in modern dentistry.

Discussion

Strengths:

• Broad scope covering both in-vitro and in-vivo studies.
• Consistent findings demonstrating the advantages of nano-HA.
• Applicability across preventive, restorative, and regenerative dentistry.

Weaknesses:

• Limitations in study standardization (e.g., variability in brushing protocols).
• Lack of long-term clinical studies directly comparing nano-HA to fluoride in large populations.

Citation

Pepla E, et al. Nano-hydroxyapatite and its applications in preventive, restorative, and regenerative dentistry: a review of literature. Ann Stomatol (Roma). 2014;5(3):108-114. PubMed Link

Visual Aids

Chart: Primary Outcome Variables and Results