Biomimetic remineralization of enamel and dentin: a review of the literature
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Published:
Jul 28, 2025
Keywords:
Dentistry, biomimicry, remineralization, enamel dentin, anti-adhesives.
Main Article Content
Abstract
Objective. To analyze the literature regarding enamel and dentin remineralization with biomimetic materials to understand their effectiveness and clinical applications. Methodology. Comprehensive research of scientific articles was conducted that included in vitro studies, systematic reviews, and meta-analyses published between 2019 and 2024. The databases consulted were Pubmed, Science Direct, and Springer Link and Google academic was used as a secondary search engine. Results. Despite all the promising studies, biomimetic strategies still face challenges in the field of dentistry. Conclusion. Biomimetic remineralization has evolved from an experimental concept to an emerging clinical reality, establishing P11-4 peptides, stabilized CPP-ACP dentifrices, and zinc-carbonate hydroxyapatite as viable therapeutic options for immediate implementation. The trend toward multifunctional materials combining remineralizing, antibacterial, and anti-adhesive properties represents a paradigmatic evolution that transcends traditional restorative approaches toward comprehensive tissue regeneration. Despite promising evidence, a critical gap persists between abundant laboratory research and limited clinical evidence requiring priority attention. Biomimetic remineralization possesses transformative potential to revolutionize preventive and therapeutic management of dental caries, transitioning toward a regenerative model that could significantly reduce the burden of oral disease at the population level. General Area of Study: Medicine. Specific area of study: Dentistry. Type of study: Systematic bibliographic review
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How to Cite
Sauca Chalán, N. P., Paladinez Carrión, Y. E., & Palacios Astudillo, I. A. (2025). Biomimetic remineralization of enamel and dentin: a review of the literature. Anatomía Digital, 8(3.1), 33-64. https://doi.org/10.33262/anatomiadigital.v8i3.1.3451
Section
Articulos de revisión bibliográfica
References
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18. Aboayana M, Elgayar MI, Hussein MHA. Silver nanoparticles versus chitosan nanoparticles effects on demineralized enamel. BMC Oral Health [Internet]. 2024 [cited 2024 November 02]; 24(1282). Available from: https://doi.org/10.1186/s12903-024-04982-4
19. Diez-García S, Sánchez-Martín MJ, Valiente M. The power of weak ion-exchange resins assisted by amelogenin for natural remineralization of dental enamel: an in vitro study. Odontology [Internet]. 2022 [cited 2024 November 10];110(3):545–556. Available from: https://doi.org/10.1007/s10266-022-00688-7
20. Hou A, Luo J, Zhang M, Li J, Chu W, Liang K, et al. Two-in-one strategy: a remineralizing and anti-adhesive coating against demineralized enamel. International Journal of Oral Science [Internet]. 2020 [cited 2024 November 11];12(27). Available from: https://doi.org/10.1038/s41368-020-00097-y
21. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología [Internet]. 2021 [citado 11 noviembre 2024]; 74(9):790-799. Disponible en: https://doi.org/10.1016/j.rec.2021.07.010
2. Aparna BK, Yashoda R, Manjunath PP. Remineralization of early enamel caries lesions using self‑assembling peptides P₁₁‑4: systematic review and meta‑analysis. Journal of Oral Biology and Craniofacial Research [Internet]. 2022 [cited 2024 September 22];12(3):324–331. Available from: https://doi.org/10.1016/j.jobcr.2022.03.012
3. Dawasaz AA, Togoo RA, Mahmood Z, Ahmad A, Thirumulu Ponnuraj K. Remineralization of dentinal lesions using biomimetic agents: a systematic review and meta‑analysis. Biomimetics [Internet]. 2023 [cited 2024 September 22]; 8(2): 159. Available from: https://doi.org/10.3390/biomimetics8020159
4. Butera A, Maiorani C, Gallo S, Pascadopoli M, Quintini M, Lelli M, et al. Biomimetic action of zinc hydroxyapatite on remineralization of enamel and dentin: a review. Biomimetics [Internet]. 2023 [cited 2024 September 25]; 8(1):71. Available from: https://doi.org/10.3390/biomimetics8010071
5. Xu J, Shi H, Luo J, Yao H, Wang P, Li Z, et al. Advanced materials for enamel remineralization. Front Bioeng Biotechnol [Internet]. 2022 [cited 2024 September 28]; 10. Available from: https://doi.org/10.3389/fbioe.2022.985881
6. Singer L, Fouda A, Bourauel C. Biomimetic approaches and materials in restorative and regenerative dentistry: review article. BMC Oral Health [Internet]. 2023 [cited 2024 September 28]; 23(1):105. Available from: https://doi.org/10.1186/s12903-023-02808-3
7. Fernando JR, Shen P, Yuan Y, Adams GG, Reynolds C, Reynolds EC. Remineralisation of enamel and dentine with stabilized stannous fluoride dentifrices in a randomised cross-over in situ trial. Journal of Dentistry [Internet]. 2024 [cited 2024 September 28]; 143:104895. Available from: https://doi.org/10.1016/j.jdent.2024.104895
8. Thorn AK, Lin WS, Levon JA, Morton D, Eckert GJ, Lippert F. The effect of theobromine on the in vitro de- and remineralization of enamel carious lesions. Journal of Dentistry [Internet]. 2020 [cited 2024 October 7]; 103(S):100013. Available from: https://doi.org/10.1016/j.jjodo.2020.100013
9. Wierichs RJ, Carvalho TS, Wolf TG. Efficacy of a self-assembling peptide to remineralizer initial caries lesions: A systematic review and meta-analysis. Journal of Dentistry [Internet]. 2021 [cited 2024 October 7]; 109:103652. Available from: https://doi.org/10.1016/j.jdent.2021.103652
10. Toledano M, Osorio E, Osorio MT, Aguilera FS, Toledano R, Fernández-Romero E, et al. Dexamethasone-doped nanoparticles improve mineralization, crystallinity, and collagen structure of human dentin. Journal of Dentistry [Internet]. 2023 [cited 2024 October 19]; 130:104447. Available from: https://doi.org/10.1016/j.jdent.2023.104447
11. Xu VW, Yin IX, Niu JY, Yu OY, Nizami MZI, Chu CH. The anti-caries effects of copper tetraamine fluoride on enamel: an in vitro study. Journal of Dentistry [Internet]. 2024 [cited 2025 October 19]; 151:105446. Available from: https://doi.org/10.1016/j.jdent.2024.105446
12. Alambiaga-Caravaca AM, Chou YF, Moreno D, Aparicio C, López-Castellano A, Feitosa VP, et al. Characterization of experimental flowable composites containing fluoride-doped calcium phosphates as promising remineralizing materials. Journal of Dentistry [Internet]. 2024 [cited 2025 October 21]; 143: 104906. Available from: https://doi.org/10.1016/j.jdent.2024.104906
13. Araújo IJDS, Guimarães GN, Machado RA, Bertassoni LE, Davies RPW, Puppin-Rontani RM. Self-assembly peptide P11-4 induces mineralization and cell-migration of odontoblast-like cells. Journal of Dentistry [Internet]. 2022 [cited 2025 October 21]; 121:104111. Available from: https://doi.org/10.1016/j.jdent.2022.104111
14. Hamdi K, Elsebaai A, Abdelshafi MA, Hamama HH. Remineralization and anti-demineralization effect of orthodontic adhesives on enamel surrounding orthodontic brackets: a systematic review of in vitro studies. BMC Oral Health [Internet]. 2024 [cited 2024 October 25]; 24(1446). Available from: https://doi.org/10.1186/s12903-024-05237-y
15. Sakr AH, Nassif MS, El-Korashy DI. Amelogenin-inspired peptide, calcium phosphate solution, fluoride, and their synergistic effect on enamel biomimetic remineralization: an in vitro pH-cycling model. BMC Oral Health [Internet]. 2024 [cited 2024 October 28]; 24(279). Available from: https://doi.org/10.1186/s12903-024-04008-z
16. Asgartooran B, Bahadori A, Khamverdi Z, Ayubi E, Farmany A. Effect of different boron contents within boron-doped hydroxyapatite-chitosan nanocomposite on the microhardness of demineralized enamel. BMC Oral Health [Internet]. 2024 [cited 2024 November 01]; 24(1419). Available from: https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-05194-6
17. Rao AC, Kondas VV, Nandini V, Kirana R, Yadalam PK, Eswaramoorthy R. Evaluating the effect of poly (amidoamine) treated bioactive glass nanoparticle incorporated in universal adhesive on bonding to artificially induced caries affected dentin. BMC Oral Health [Internet]. 2023 [cited 2024 November 02]; 23(810). Available from: https://doi.org/10.1186/s12903-023-03536-4
18. Aboayana M, Elgayar MI, Hussein MHA. Silver nanoparticles versus chitosan nanoparticles effects on demineralized enamel. BMC Oral Health [Internet]. 2024 [cited 2024 November 02]; 24(1282). Available from: https://doi.org/10.1186/s12903-024-04982-4
19. Diez-García S, Sánchez-Martín MJ, Valiente M. The power of weak ion-exchange resins assisted by amelogenin for natural remineralization of dental enamel: an in vitro study. Odontology [Internet]. 2022 [cited 2024 November 10];110(3):545–556. Available from: https://doi.org/10.1007/s10266-022-00688-7
20. Hou A, Luo J, Zhang M, Li J, Chu W, Liang K, et al. Two-in-one strategy: a remineralizing and anti-adhesive coating against demineralized enamel. International Journal of Oral Science [Internet]. 2020 [cited 2024 November 11];12(27). Available from: https://doi.org/10.1038/s41368-020-00097-y
21. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología [Internet]. 2021 [citado 11 noviembre 2024]; 74(9):790-799. Disponible en: https://doi.org/10.1016/j.rec.2021.07.010