Remineralization Potential of a Combination of Chitosan with Nanohydroxyapatite and a Self-assembling Peptide with Nanohydroxyapatite: An In Vitro Study
Keywords :
Chitosan, Nanohydroxyapatite, Remineralization, Self-assembly peptide, White spot lesion
Citation Information :
Rangappa KG, Garain R, Ahmad ZH, Jain K, Arroju R, Boregowda V. Remineralization Potential of a Combination of Chitosan with Nanohydroxyapatite and a Self-assembling Peptide with Nanohydroxyapatite: An In Vitro Study. J Contemp Dent Pract 2022; 23 (12):1255-1259.
Aim: This study explores the demineralizing potential of the combination of chitosan with nanohydroxyapatite (n-HA) and self-assembling peptides with n-HA.
Materials and methods: A total of 66 first premolar teeth of similar dimensions extracted for orthodontic purposes were collected for this study. These were then demineralized and randomly divided into the following three groups (n = 22): (i) Control group, (ii) n-HA + Chitosan (HAC), and (iii) self-assembling peptide + n-HA (SP-HA). The samples in each group were brushed every 24 hours with the respective agent. The specimens were stored in Fusayama Meyer's artificial saliva at room temperature and the solution was replenished daily. Mineral content (Ca, P) and surface morphology of the specimens was analyzed, using scanning electron microscopy and energy dispersion X-ray spectroscopy (SEM-EDAX), before demineralization, at 15 days of remineralization and 30 days of remineralization. A two-way analysis of variance (ANOVA) test followed by Tukey's honest significant difference (HSD) post hoc analysis was used to compare the mean elemental composition of the different groups (p < 0.05).
Results: There was no significant difference in the calcium (Ca) and phosphate (P) weight percentage between the different groups at the baseline and after demineralization. The Ca and P weight percentages of all three groups after remineralization for 15 and 30 days showed no significant difference from the baseline or after demineralization. The surface morphology after 15 days of remineralization therapy showed decreased surface porosity and increased mineral deposition in the HAC group than the HP-SA group. Surface morphology after 30 days of remineralization showed a more homogenous and smoother surface in the HAC group than the HP-SA group.
Conclusion: From the results of this study, it can be concluded that the combination of chitosan with n-HA and self-assembling peptides with n-HA can be considered effective demineralizing agents.
Clinical significance: Considering the non-invasive nature of remineralization therapy understanding the effectiveness of different agents is of utmost importance. The demineralizing properties of chitosan, n-HA and self-assembling peptides make their combinations ideal for studying their effectiveness in treating white spot lesions.
Janakiram C, Antony B, Joseph J, et al. Prevalence of dental caries in India among the WHO index age groups: A meta-analysis. J Clin Diagnostic Res 2018;12(8):ZE08–ZE13. DOI: 10.7860/JCDR/2018/32669.11956.
Abou Neel EA, Aljabo A, Strange A, et al. Demineralization–remineralization dynamics in teeth and bone. Int J Nanomedicine 2016;11:4735–4741. DOI: 10.2147/IJN.S107624.
Featherstone JD, Doméjean S. The role of remineralizing and anticaries agents in caries management. Adv Dent Res 2012;24(2):28–31. DOI: 10.1177/0022034512452885.
Ten Cate JM. Novel anticaries and remineralizing agents: Prospects for the future. J Dent Res 2012;91(9):813–815. DOI: 10.1177/0022034512455032.
González–Cabezas C, Fernández CE. Recent advances in remineralization therapies for caries lesions. Adv Dent Res 2018;29(1):55–59. DOI 10.1177/0022034517740124.
Huang SB, Gao SS, Yu HY. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomed Mater 2009;4(3):034104.
Kirkham J, Firth A, Vernals D, et al. Self-assembling peptide scaffolds promote enamel remineralization. J Dent Res 200786(5):426–430. DOI: 10.1177/154405910708600507.
Rinaudo M. Chitin and chitosan: Properties and applications. Prog Polym Sci 2006;31(7):603–632. DOI: 10.1016/j.progpolymsci.2006.06.001.
Sahariah P, Másson M. Antimicrobial chitosan and chitosan derivatives: A review of the structure–activity relationship. Biomacromolecules 2017;18(11):3846–3868. DOI: 10.1021/acs.biomac.7b01058.
Krithikadatta J, Gopikrishna V, Datta M. CRIS guidelines (checklist for reporting in vitro studies): A concept note on the need for standardized guidelines for improving quality and transparency in reporting in vitro studies in experimental dental research. J Conserv Dent 2014;17(4):301–304. DOI: 10.4103/0972-0707.136338.
Lata S, Varghese N, Varughese J. Remineralization potential of fluoride and amorphous calcium phosphate–casein phosphopeptide on enamel lesions: An in vitro comparative evaluation. J Conserv Dent 2010;13(1):42–46. DOI: 10.4103/0972-0707.62634.
Nagarathana C, Sakunthala BK, Naveena Preethi P. An update on current remineralizing agent an update on current remineralizing agent. OHDM 2015:14(4):183–187.
Kamh RA, Niazy MA, El-Yasaky MA. Clinical performance and remineralization potential of different biomimitic materials on white spot lesions. Al-Azhar Dent J Girls 2018;5(4):349–358. DOI: 10.21608/ADJG.2018.20020.
Philip N. State of the art enamel remineralization systems: The next frontier in caries management. Caries Res 2019;53(3):284–295. DOI: 10.1159/000493031.
Kamal D, Hassanein H, Elkassas D, et al. Comparative evaluation of remineralizing efficacy of biomimetic self-assembling peptide on artificially induced enamel lesions: An in vitro study. 2021;21(5):536–541. DOI: 10.4103/JCD.JCD_123_18.
Babaji P, Melkundi M, Bhagwat P, et al. An in vitro evaluation of remineralizing capacity of self-assembling peptide (SAP) P11-4 and casein phosphopeptides–amorphous calcium phosphate (CPP-ACP) on artificial enamel. Pesqui Bras Odontopediatria Clin Integr 2019;19(1):10–16. DOI: 10.4034/PBOCI.2019.191.23.
Husain S, Al-Samadani KH, Najeeb S, et al. Chitosan biomaterials for current and potential dental applications. Materials (Basel) 2017;10(6):602. DOI: 10.3390/ma10060602
Ceci M, Mirando M, Beltrami R, et al. Effect of self-assembling peptide P 11-4 on enamel erosion: AFM and SEM studies. Scanning 2016;38:344–351. DOI: 10.1002/sca.21276.
Vinod D, Gopalakrishnan A, Subramani SM, et al. A comparative evaluation of remineralizing potential of three commercially available remineralizing agents: An in vitro study. 2020;13(1):61–65. DOI: 10.5005/jp-journals-10005-1715.
Sharma A, Rao A, Shenoy R, et al. Comparative evaluation of nano-hydroxyapatite and casein phosphopeptide–amorphous calcium phosphate on the remineralization potential of early enamel lesions: An in vitro study. J Orofac Sci 2017;9(1):28–33. DOI: 10.4103/0975-8844.207941.