In Vitro Models Used in Cariology Mineralisation Research-A Review of the Literature

Abstract

Background: Dental caries remains a significant global health problem. One of the fundamental mechanisms underlying the development and progression of dental caries is the dynamic process of demineralisation/remineralisation. In vitro models have played a critical role in advancing our understanding of this process and identifying potential interventions to prevent or arrest dental caries. This literature review aims to provide a structured oversight of in vitro mineralisation models which have been used to study the tooth demineralisation/remineralisation process.

Methods: Publications from 2019 to 2023 were screened to identify articles reporting the use of in vitro models to study the demineralisation/remineralisation of tooth caries. The included studies were methodologically assessed for their information on (i) substrate, (ii) lesion formation, and (iii) mineralisation models.

Results: The most reported substrates used in the studies were human teeth along with bovine incisors. Acetic/lactic buffers were the most common solutions to induce caries lesions. pH cycling was the most frequently used mineralisation model for simulating the daily change within the oral environment. This review discussed the advantages and limitations of various approaches.

Conclusions: Standardisation of in vitro mineralisation models is crucial for enabling effective comparison between studies and advancing caries research.

Keywords: demineralisation; dental caries; dentine; enamel; in vitro; mineralisation; remineralisation.

Figure 1

Flow diagram to select resources for analysis (inspired by PRISMA 2020) [9].

Figure 2

Flowchart showing the reported frequency of methodologies used and reporting of the different aspects of the studies. These data potentially provide a guide for future in vitro studies on mineralisation research in cariology. The percentage values (in brackets) shown in the flowchart indicate the frequency of use for each procedure as identified from the manuscripts included in our bibliometric study (further detail: * refer to Table 1, ** refer to Table 2 and Table 3, *** refer to Table 4).

Figure 3

An appropriately designed enamel surface preparation with two internal controls. (a) Optical microscope image; (b) micro-computed tomography image. SE: sound enamel (sound control); DE: demineralised enamel (demineralised control); TE: treated enamel (test surface) [31], copyright license number 5835700478415.