Targeted enamel remineralization with mineral-loaded starch particlesWhy Is This Important?

Background: Noninvasive caries treatments work topically, which may limit efficacy. The authors hypothesized that an alternative approach using mineral-loaded particles designed to target the subsurface of noncavitated caries lesions could be advantageous. This study shows in vitro proof-of-concept....

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Main Authors: Nathan A. Jones, PhD, Li-Chi Pan, MEng, Susan E. Flannagan, MS, Kai A. Jones, MD, Lyudmila Lukashova, MS, Lucas Wightman, BEng, Sywe-Ren Chang, MS, Glenn Jones, MD, Livia M.A. Tenuta, DDS, PhD, Carlos González-Cabezas, DDS, PhD, Brian H. Clarkson, DDS, PhD, Wendy Bloembergen, MD, Steven Bloembergen, PhD
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:JADA Foundational Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772414X24000112
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author Nathan A. Jones, PhD
Li-Chi Pan, MEng
Susan E. Flannagan, MS
Kai A. Jones, MD
Lyudmila Lukashova, MS
Lucas Wightman, BEng
Sywe-Ren Chang, MS
Glenn Jones, MD
Livia M.A. Tenuta, DDS, PhD
Carlos González-Cabezas, DDS, PhD
Brian H. Clarkson, DDS, PhD
Wendy Bloembergen, MD
Steven Bloembergen, PhD
author_facet Nathan A. Jones, PhD
Li-Chi Pan, MEng
Susan E. Flannagan, MS
Kai A. Jones, MD
Lyudmila Lukashova, MS
Lucas Wightman, BEng
Sywe-Ren Chang, MS
Glenn Jones, MD
Livia M.A. Tenuta, DDS, PhD
Carlos González-Cabezas, DDS, PhD
Brian H. Clarkson, DDS, PhD
Wendy Bloembergen, MD
Steven Bloembergen, PhD
author_sort Nathan A. Jones, PhD
collection DOAJ
description Background: Noninvasive caries treatments work topically, which may limit efficacy. The authors hypothesized that an alternative approach using mineral-loaded particles designed to target the subsurface of noncavitated caries lesions could be advantageous. This study shows in vitro proof-of-concept. Methods: Mineral-loaded cationic starch (MLCS) particles were prepared, containing calcium, phosphate, and fluoride to provide fluoride-plus (FP) and fluoride-free (FF) alternatives. Particles were characterized for mineral loading and release. MLCS-FP and -FF treatments vs 1,000 ppm fluoride and deionized water controls were evaluated on natural smooth-surface caries lesions (n = 15 per group) after a 20-day protocol with immersion in artificial saliva with amylase and acid challenge. Treatment efficacy was assessed by microcomputed tomography, labeled fluorescence imaging, and blinded qualitative visual assessment. Results: In aqueous suspension and absent amylase, particles showed sustained mineral ion release. The tomographic evaluation found significant (multivariable regression analysis, P < .05) restoration of lesion mineral density by MLCS-FP and MLCS-FF (42.9% and 38.6%, respectively) vs fluoride and negative controls (7.4% and −18%, respectively), particularly for the lesion subsurface (13.8% [13.0%], 15.9% [9.4%], −2.2% [7.3%], and −1.8% [4.0%] relative hydroxyapatite density for 0.25 through 0.45 μm lesion depth for FP, FF, fluoride, and deionized water, respectively). Visually reduced white opacity (Fisher exact test, P = .038, MLCS-FF vs fluoride) and labeled fluorescence (analysis of variance, P < .05 for MLCS-FF [75.4%], MLCS-FP [75.7%], fluoride [64.1%] vs negative control [−0.2%]) were observed. Conclusions: These foundational studies show the potential of mineral-loaded starch particles to remineralize enamel as a new approach to treating early caries by subsurface targeted mineral delivery. The in vitro study results indicated that targeted particles improved treatment efficacy, with the data supporting the superiority of MLCS-FP and FF formulations over control conditions for subsurface remineralization and visual esthetic.
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spelling doaj-art-2d283f4406a54694a7a23448e7a378a02025-08-20T02:27:39ZengElsevierJADA Foundational Science2772-414X2024-01-01310004110.1016/j.jfscie.2024.100041Targeted enamel remineralization with mineral-loaded starch particlesWhy Is This Important?Nathan A. Jones, PhD0Li-Chi Pan, MEng1Susan E. Flannagan, MS2Kai A. Jones, MD3Lyudmila Lukashova, MS4Lucas Wightman, BEng5Sywe-Ren Chang, MS6Glenn Jones, MD7Livia M.A. Tenuta, DDS, PhD8Carlos González-Cabezas, DDS, PhD9Brian H. Clarkson, DDS, PhD10Wendy Bloembergen, MD11Steven Bloembergen, PhD12GreenMark Biomedical Inc, East Lansing and Ann Arbor, MI; Address correspondence to Dr Jones.GreenMark Biomedical Inc, East Lansing and Ann Arbor, MISchool of Dentistry, University of Michigan, Ann Arbor, MIDepartment of Radiology, Montefiore Medical Center, Bronx, NYCenter for Craniofacial Regeneration, School of Dentistry, University of Pittsburgh, Pittsburgh, PAGreenMark Biomedical Inc, East Lansing and Ann Arbor, MISchool of Dentistry, University of Michigan, Ann Arbor, MISchool of Medicine, Saba University, Devens, MASchool of Dentistry, University of Michigan, Ann Arbor, MISchool of Dentistry, University of Michigan, Ann Arbor, MISchool of Dentistry, University of Michigan, Ann Arbor, MIGreenMark Biomedical Inc, East Lansing and Ann Arbor, MIGreenMark Biomedical Inc, East Lansing and Ann Arbor, MIBackground: Noninvasive caries treatments work topically, which may limit efficacy. The authors hypothesized that an alternative approach using mineral-loaded particles designed to target the subsurface of noncavitated caries lesions could be advantageous. This study shows in vitro proof-of-concept. Methods: Mineral-loaded cationic starch (MLCS) particles were prepared, containing calcium, phosphate, and fluoride to provide fluoride-plus (FP) and fluoride-free (FF) alternatives. Particles were characterized for mineral loading and release. MLCS-FP and -FF treatments vs 1,000 ppm fluoride and deionized water controls were evaluated on natural smooth-surface caries lesions (n = 15 per group) after a 20-day protocol with immersion in artificial saliva with amylase and acid challenge. Treatment efficacy was assessed by microcomputed tomography, labeled fluorescence imaging, and blinded qualitative visual assessment. Results: In aqueous suspension and absent amylase, particles showed sustained mineral ion release. The tomographic evaluation found significant (multivariable regression analysis, P < .05) restoration of lesion mineral density by MLCS-FP and MLCS-FF (42.9% and 38.6%, respectively) vs fluoride and negative controls (7.4% and −18%, respectively), particularly for the lesion subsurface (13.8% [13.0%], 15.9% [9.4%], −2.2% [7.3%], and −1.8% [4.0%] relative hydroxyapatite density for 0.25 through 0.45 μm lesion depth for FP, FF, fluoride, and deionized water, respectively). Visually reduced white opacity (Fisher exact test, P = .038, MLCS-FF vs fluoride) and labeled fluorescence (analysis of variance, P < .05 for MLCS-FF [75.4%], MLCS-FP [75.7%], fluoride [64.1%] vs negative control [−0.2%]) were observed. Conclusions: These foundational studies show the potential of mineral-loaded starch particles to remineralize enamel as a new approach to treating early caries by subsurface targeted mineral delivery. The in vitro study results indicated that targeted particles improved treatment efficacy, with the data supporting the superiority of MLCS-FP and FF formulations over control conditions for subsurface remineralization and visual esthetic.http://www.sciencedirect.com/science/article/pii/S2772414X24000112Cariesnanotechnologyremineralizationnoninvasive treatmentnoncavitated carious lesionsesthetics
spellingShingle Nathan A. Jones, PhD
Li-Chi Pan, MEng
Susan E. Flannagan, MS
Kai A. Jones, MD
Lyudmila Lukashova, MS
Lucas Wightman, BEng
Sywe-Ren Chang, MS
Glenn Jones, MD
Livia M.A. Tenuta, DDS, PhD
Carlos González-Cabezas, DDS, PhD
Brian H. Clarkson, DDS, PhD
Wendy Bloembergen, MD
Steven Bloembergen, PhD
Targeted enamel remineralization with mineral-loaded starch particlesWhy Is This Important?
JADA Foundational Science
Caries
nanotechnology
remineralization
noninvasive treatment
noncavitated carious lesions
esthetics
title Targeted enamel remineralization with mineral-loaded starch particlesWhy Is This Important?
title_full Targeted enamel remineralization with mineral-loaded starch particlesWhy Is This Important?
title_fullStr Targeted enamel remineralization with mineral-loaded starch particlesWhy Is This Important?
title_full_unstemmed Targeted enamel remineralization with mineral-loaded starch particlesWhy Is This Important?
title_short Targeted enamel remineralization with mineral-loaded starch particlesWhy Is This Important?
title_sort targeted enamel remineralization with mineral loaded starch particleswhy is this important
topic Caries
nanotechnology
remineralization
noninvasive treatment
noncavitated carious lesions
esthetics
url http://www.sciencedirect.com/science/article/pii/S2772414X24000112
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