Journal of Stomatology

Abstract

3/2025 vol. 78
Original paper

Comparative evaluation of different re-mineralizing agents for enamel protection after pH-cycling

Ali Shyaa Al-Saadi 1, 2
,
Ahmed Gamal El-Din Nafady 3
,
Nabil Abd Al-Hameed Al-Aggan 4, 5
,
Abdelrahman Adel Hasan 3
,
Nasser Mohey Shehab 4
,
Nafesa Mostafa Sakr 6
,
Mahmoud Elsayed Fetouh 7
,
Hatem Abdul-Monaem El-Bially 7
  1. Department of Orthodontics Dentistry, Al Maaqal Private University, Basrah, Iraq
  2. Department of Orthodontics Dentistry, University of Basrah, Iraq
  3. Department of Prosthodontic Dentistry, Al Maaqal Private University, Basrah, Iraq
  4. Department of Operative Dentistry, Faculty of Dental Medicine (Cairo-Boys), Al-Azhar University, Cairo, Egypt
  5. Department of Conservative Dentistry, Al Maaqal Private University, Basrah, Iraq
  6. Department of Operative Dentistry, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
  7. Department of Operative Dentistry, Faculty of Dental Medicine (Assiut Branch), Al-Azhar University, Assiut, Egypt
J Stoma 2025; 78, 3: 176-185
DOI: https://doi.org/10.5114/jos.2025.154418
Online publish date: 2025/09/22
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Introduction

Dental caries has evolved from a surgical approach focusing on restorative treatment to a medical model emphasizing disease prevention and tooth structure conservation.

Objectives

Comparative evaluation of three different re-mineralizing agents, including nano-bioactive glass (N-BAG), chitosan-loaded nano-hydroxyapatite (CS/N-HAp), and nano-silver fluoride (NSF), for their ability to prevent sound enamel from de-mineralization after pH-cycling.

Material and methods

A total of 40 premolars were equally divided into four groups (n = 10) according to the re-mineralizing agent used. Group 1: N-BAG, group 2: CS/N-Hap, group 3: NSF, and group 4 (control group): no re-mineralizing agent applied. Samples underwent pH-cycling for 7 days. Each cycle involved two de-minerali­zation cycles and 18 hours of artificial saliva immersion. Re-mineralizing regimen was performed before and after de-mineralization cycles. Control group did not receive any re-mineralizing agent, and was subjected to the same pH-cycling procedures. Environmental scanning electron microscopy (ESEM) with a built-up energy dispersive X-ray unit was used to assess surface morphology and mineral content before pH-cycling and after pH-cycling.

Results

The ESEM results indicated that group 1 (N-BAG) showed the best preservation of enamel structure, while group 4 (control group) displayed the most eroded surface. After pH-cycling, there was a significant increase in mineral content, with group 1 (N-BAG) demonstrated the highest range of calcium and phosphorus gain, and carbon loss, followed by group 2 (CS/N-HAp) and group 3 (NSF).

Conclusions

The tested re-mineralizing agents presented varying degrees of efficacy in resisting acidic enamel erosion. However, the N-BAG agent showed superior mineral gain and enamel protection against acidic challenges.

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Keywords

nano-bioactive glass, chitosan-loaded nano-hydroxyapatite, nano-silver fluoride, enamel re-minera­lization, de-mineralization prevention

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