Recent advances in preventive agents for early enamel caries lesions: scoping Review

Abstract

Dental caries continues to be a widespread global health concern, highlighting the need for effective preventive and therapeutic measures. Recent advancements in nanotechnology have introduced innovative agents such as nano-hydroxyapatite (Nano-HAP), nano silver fluoride (NSF), and biomimetic technologies like the self-assembling peptide P11-4 (SAP P11-4) for enamel remineralisation and caries prevention. Aim: This scoping review aimed to assess the current research on the efficacy of Nano-HAP, NSF, and SAP P11-4 in remineralising early enamel carious lesions. Methods: A thorough literature search was performed across several databases, including PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials, covering publications from 2010 to 2024. Studies were selected based on predefined inclusion and exclusion criteria, focusing on in vitro and clinical trials involving Nano-HAP, NSF, and SAP P11-4. Results: A total of 32 studies were included, comprising 18 in vitro investigations and 14 clinical trials. The findings indicate that Nano-HAP demonstrates superior surface remineralisation and biocompatibility, NSF offers strong antimicrobial properties and effective remineralisation without enamel staining, and SAP P11-4 provides a biomimetic approach to enamel repair. However, variations in study design, sample sizes, and methodologies contribute to heterogeneity in the results. Conclusion: The integration of Nano-HAP, NSF, and SAP P11-4 into dental care protocols presents a promising multifaceted approach to enamel remineralisation. Future research should prioritise larger, multicentre trials to validate these findings and explore the long-term effects of these treatments. Comparative studies involving head-to-head trials of these agents could provide more definitive evidence of their relative efficacy.