The role of salivary contents and modern technologies in the remineralization of dental enamel: a narrative review

Abstract

Human enamel once formed cannot be biologically repaired or replaced. Saliva has a significant role in remineralization of dental enamel. It not only has a buffering capacity to neutralize the oral cavity's low pH generated after acidic encounters, but also acts as a carrier of essential ions, such as fluoride, calcium and phosphate, which have a positive role in enamel's remineralization. This review discusses how salivary contents, like proteins and enzymes, have a natural role in enamel's mineralization. In addition, the presence of ions, such as fluoride, calcium and phosphate, in saliva further enhances its capability to remineralize the demineralized enamel surface. The review further examines modern innovative technologies, based on biomimetic regeneration systems, including dentin phosphoproteins, aspartate-serine-serine, recombinant porcine amelogenin, leucine-rich amelogenin peptide and nano-hydroxyapatite, that promote enamel remineralization. Fluoride boosters like calcium phosphates, polyphosphates, and certain natural products can also play an important role in enamel remineralization.

Keywords: Calcium Phosphate; Enamel; Fluoride; Remineralization; Saliva.

Figure 1.. Flow chart depicting search strategy included in this article.

Figure 2.

Micro-computed tomography (micro-CT) image of enamel surface A) Ground and polished B) Remineralized enamel surface after 24 hours of exposure to a mixture of fluoride toothpaste and distilled water (Courtesy Dr. Saqib Ali, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia).