Biomimetic Remineralization of Dental Caries

Dental caries is a two step process First, the bacteria metabolize fermentable carbohydrates producing organic acids that diffuse into the tooth through the water amongst the crystals. When the acid reaches a susceptible site on a crystal surface calcium and phosphate are dissolved into the surrounding aqueous phase between the crystals. This is the first stage of demineralization which is occurring at the atomic level far before it can be seen visually as gross demineralization, that can eventually lead to cavitation. Whether demineralization or remineralization is proceeding at any one time is determined by the balance between pathological factors and protective factors. The key factors are illustrated as part of the so-called ‘‘caries balance’’. Remineralization is the natural repair process for non-cavitated lesions, and relies on calcium and phosphate ions assisted by fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. Remineralization are based on biomimetic remineralization materials, having the capability to create apatite crystals within the completely demineralized collagen.