Repair of tooth enamel by a biomimetic mineralization frontier ensuring epitaxial growth

Next-Generation Strategies for Enamel Repair and Regeneration: Advances in Biomaterials and Translational Challenges

BACKGROUND

Enamel regeneration and remineralization are critical for restoring enamel integrity, as natural enamel lacks the ability to regenerate due to the absence of ameloblasts. The increasing prevalence of dental caries and the irreversible nature of enamel damage highlight the need for advanced repair strategies.

METHODS

This review examines the latest advancements in enamel regeneration and remineralization, focusing on biomaterials, nanotechnology-based approaches, and bioengineering strategies. Google Scholar, Scopus (Elsevier), and PubMed databases were used for the selection of literature. The search included key terms such as "enamel regeneration," "biomimetic enamel repair," "stem cell-based enamel regeneration," "nanotechnology in enamel repair," "hydroxyapatite enamel remineralization," and "biomaterials for enamel remineralization."

RESULTS

Various strategies have been explored for enamel remineralization, including self-assembling peptides, dendrimers, hydrogels, and electrospun mats, each demonstrating varying success in laboratory and preclinical studies. While casein-phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP) combined with fluoride remains a widely used clinical remineralization agent, integrating CPP-ACP with nanotechnology is an emerging area requiring further research. Enamel bioengineering approaches utilizing stem/progenitor cells offer potential, though challenges remain in achieving clinical translation.

CONCLUSION

Despite advancements, replicating the hierarchical structure and mechanical properties of natural enamel remains challenging. Nanotechnology-driven approaches, bioengineered scaffolds, and interdisciplinary collaboration hold promise for optimizing enamel regeneration techniques. Further research is necessary to enhance clinical applicability and develop scalable, effective treatments for enamel restoration.

Potential of High-Intensity Focused Ultrasound in Enamel Remineralization

Remineralization is an essential interventional strategy for intercepting enamel white spot lesions (WSLs). Given the limitations of both natural and/or fluoride-mediated repair processes, there is a need to develop novel strategies for repairing enamel WSLs via a minimally invasive approach while restoring the unique ultrastructural integrity and functional properties. Inspired by the unique capability of high-intensity focused ultrasound (HIFU) in facilitating the crystallization process, we propose a novel strategy of employing HIFU for in vitro repair of WSLs through synergizing the crystallization process required for hydroxyapatite (HAP) formation from its precursor (calcium phosphate ion clusters; CPICs). Following CPIC formulation and characterization including the resultant amorphous calcium phosphate (ACP), the effect of HIFU on the ACP-to-HAP transition on the amorphous substrate was investigated using transmission electron microscopy and high-resolution transmission electron microscopy, selected area electron diffraction, and X-ray diffraction (XRD). The results showed profound amorphous-to-crystalline phase transition, within 5- to 30-min HIFU exposure, whereas the long axis of the resultant HAP corresponded with the (002) plane, and a lattice spacing of 0.34 nm indicated a preferred c-axis growth direction consistent with the orientation of natural enamel crystallites. For enamel repair, artificial WSLs were created on enamel specimens and then subjected to CPICs, followed by HIFU exposure for 2.5, 5, or 10 min. Scanning electron and atomic force microscopies revealed the decreased surface roughness and the gradual obliteration in the WSL porous structure with continuous linear coaxial arrangement of HAP crystallites filling the prismatic/interprismatic gaps closely resembling sound enamel specifically with 5-min HIFU exposure. Enamel WSL ultrastructural repair was further confirmed from XRD and Raman spectral analyses with the associated regaining of mineral density and nanomechanical properties as reflected from micro-computed tomography (CT) and nanoindentation results, respectively. Micro-CT further validated the subsurface remineralization of WSLs with HIFU exposure. Within the same exposure parameters, HIFU exhibited a potent antibiofilm effect against Streptococcus mutans. This study introduced a new approach for remineralizing enamel WSLs through the potent synergy between HIFU and CPICs.

Bioinspired Materials for Controlling Mineral Adhesion: From Innovation Design to Diverse Applications

The advancement of controllable mineral adhesion materials has significantly impacted various sectors, including industrial production, energy utilization, biomedicine, construction engineering, food safety, and environmental management. Natural biological materials exhibit distinctive and controllable adhesion properties that inspire the design of artificial systems for controlling mineral adhesion. In recent decades, researchers have sought to create bioinspired materials that effectively regulate mineral adhesion, significantly accelerating the development of functional materials across various emerging fields. Herein, we review recent advances in bioinspired materials for controlling mineral adhesion, including bioinspired mineralized materials and bioinspired antiscaling materials. First, a systematic overview of biological materials that exhibit controllable mineral adhesion in nature is provided. Then, the mechanism of mineral adhesion and the latest adhesion characterization between minerals and material surfaces are introduced. Later, the latest advances in bioinspired materials designed for controlling mineral adhesion are presented, ranging from the molecular level to micro/nanostructures, including bioinspired mineralized materials and bioinspired antiscaling materials. Additionally, recent applications of these bioinspired materials in emerging fields are discussed, such as industrial production, energy utilization, biomedicine, construction engineering, and environmental management, highlighting their roles in promoting or inhibiting aspects. Finally, we summarize the ongoing challenges and offer a perspective on the future of this charming field.

Design and characterization of a ROS-responsive antibacterial composite hydrogel for advanced full-thickness wound healing

Full-thickness skin wounds remian a significant and pressing challenge. In this study, we introduce a novel composite hydrogel, CS + GA + Zn-HA. This hydrogel is formulated by incorporating 1 % (1 g/100 mL) of bioactive Zinc-substituted hydroxyapatite nanoparticles (Zn-HA) and 0.2 % (0.2 g/100 mL) of Gallic acid (GA) into chitosan (CS) hydrogels. A 56 % β-glycerophosphate sodium (β-GP) solution serves as the cross-linking agent, and the hydrogel is formed at 37 °C. This composite hydrogel can effectively modulate the wound microenvironment, facilitating comprehensive skin wound healing within two weeks. Physicochemical characterization demonstrates that this hydrogel is thermosensitive, with remarkable swelling behavior, mechanical strength, and drug-delivery performance. In vitro, the GA-incorporated hydrogels possess outstanding reactive oxygen species (ROS) scavenging and antioxidant properties, protecting L929 cells from hydrogen peroxide-induced oxidative damage. The combination of Zn-HA nanoparticles and GA not only augments the functionality of the hydrogel and decreases its degradation rate but also enables the controlled release of curcumin. Moreover, it provides a suitable immune microenvironment in terms of biological effects and significantly boosts the hydrogel's antibacterial ability, as demonstrated by an 89.2 % reduction in E. coli and a 53.6 % reduction in S. aureus. Benefiting from these properties, the CS + GA + Zn-HA composite hydrogel significantly promotes granulation tissue formation, re-epithelialization, angiogenesis, and wound closure in vivo. In conclusion, our research highlights the potential of the CS + GA + Zn-HA hydrogel as a multifunctional scaffold in tissue engineering, providing valuable insights for the design of future wound dressings for diverse wound types.

Controllable Polymerization of Inorganic Ionic Oligomers for Precise Nanostructural Construction in Materials

The rational design of nanostructures is critical for achieving high-performance materials. The close-packing behavior of inorganic ions and their less controllable nucleation process impede the precise nanostructural construction of inorganic ionic compounds. The discovery of inorganic ionic oligomers (stable molecular-scale inorganic ionic compounds) and their polymerization reaction enables the controllable arrangement of inorganic ions for diverse nanostructures. This perspective aims to introduce inorganic ionic oligomers and their currently identified advantages in the precise design of inorganic and organic-inorganic hybrid nanostructures, directing the development of advanced materials with applications across the mechanical, energy, environmental, and biomedical fields. The challenges and opportunities for the controllable polymerization of inorganic ionic oligomers are presented at the end of this perspective. We suggest that inorganic ionic oligomers and their polymerization reaction offer a promising strategy for the preparation of inorganic and organic-inorganic hybrid materials.

In Situ Growth of Enamel-like Apatite Coating for Marble Protection

Outdoor stone relics, including inscriptions, statues, temple grottoes, etc., are continuously subjected to natural weathering and air pollutants. Those made of marbles and other carbonate rocks are particularly vulnerable to acid rains, which can be protected by acid-resistant coatings. A novel method to prepare enamel-like hydroxyapatite coating on marble surfaces is presented in this paper and analyzed using optical microscopy, a scanning electronic microscope, grazing incident X-ray diffraction, and nano-indentation. The described coating is composed of tightly arranged hydroxyapatite nanorods, perpendicular to the marble substrate, with a thickness of 3-5 μm. Not only does the coating exhibit high acid resistance, it also has considerably higher elastic modulus and hardness compared to that synthesized by the well-known diammonium phosphate (DAP) method owing to the wellarranged microstructure. Consequently, the enamel-like hydroxyapatite coating would probably be more effective and durable for marble protection than the existing calcium phosphate coating.

Fluorapatite Glass-Ceramics in Dentistry: Synthesis, Properties, Forming Technology, Applications, Challenges, and Future Perspectives

Fluorapatite glass-ceramics (FGC) have been widely used in dental ceramics due to their excellent aesthetic properties and biocompatibility. In recent years, new synthesis methods, forming technologies, and the continuous optimization of performance attributes have driven the application of FGC in dental veneers, coatings, composites, and other restorations. This review summarizes the current research and applications of this material in the dental field and looks forward to its future optimization directions. The article focuses on five aspects: the development of preparation techniques for FGC; advances in their application in dental restoration shaping technologies; the performance advantages and limitations of these materials as dental materials; the current application status in veneers, coatings, composites, and other restorations; as well as the challenges in the current applications and prospects. In addition, additive manufacturing technology shows extremely broad application potential in FGC molding and applications. This review is hoped to provide strong guidance for the further application of FGC in the dental field, promoting the integration of related research and industry upgrades better to meet the needs of clinical practice and patients.

Underwater Superoleophobic and Transparent Films with Mechanical Robustness and High Durability in Harsh Environments

Underwater superoleophobic and transparent (UST) films are promising in applications, such as advanced optical devices in marine environments. However, the mechanical robustness and durability in harsh environments of the existing UST films are still unsatisfactory. In this work, we present a free-standing nacre-inspired mineralized UST (NIM-UST) film with high aragonite content and excellent mechanical properties toward robust underwater superoleophobicity on two surfaces and transparency (94%) in harsh seawater environments. Such NIM-UST films were fabricated by using a simple and effective magnesium ion (Mg2+)-assisted dual-side mineralization strategy. The NIM-UST films exhibit high inorganic content (87 wt %), among which the aragonite fractions can reach 98 wt %. As a result, the modulus and hardness of the resulting NIM-UST films increased by 154% (from 8.17 ± 0.37 GPa to 20.78 ± 0.94 GPa) and 190% (from 0.70 ± 0.02 GPa to 2.03 ± 0.08 GPa), respectively, compared to those of the single-side NIM-UST films. And both surfaces of the resulting NIM-UST film maintain excellent underwater superoleophobicity (oil contact angle > 150°) and low oil adhesive force (<4 μN) under conditions of high-salt solutions, high temperatures, long-term immersion in seawater, and sand shock. In addition, the NIM-UST films can also be assembled into bulk materials with high hardness (2.63 ± 0.03 GPa) and flexural strength (109.55 ± 5.91 MPa) as next-generation structural materials. The feasible strategy developed in this work can promote the development and practical application of NIM-UST films.

A Moldable, Tough Mineral-Dominated Nanocomposite as a Recyclable Structural Material

Flexible hybrid minerals, primarily composed of inorganic ionic crystal nanolines and a small amount of organic molecules, have significant potential for the development of sustainable structural materials. However, the weak interactions and insufficient crosslinking among the inorganic nanolines limit the mechanical enhancement and application of these hybrid minerals in high-strength structural materials. Inspired by tough biominerals and modern reinforced concrete structures, this study proposes introducing an aramid nanofiber (ANF) network as a flexible framework during the polymerization of calcium phosphate oligomers (CPO), crosslinked by polyvinyl alcohol (PVA) and sodium alginate (SA). This approach allows the flexible inorganic nanolines formed through CPO polymerization to be integrated into the organic framework, thereby creating tough mineral-based structural materials (inorganic content: 70.7 wt.%), denoted as PVA/SA/ANF/CPO (PSAC). The multiple intermolecular interactions between the organic and inorganic phases, combined with the integrated nano-reinforced concrete structure, endow PSAC with significantly enhanced tensile strength (86.6 ± 8.6 MPa), comparable to that of high-strength polymer plastics. Moreover, PSAC possesses excellent plasticity and flame retardancy. The noncovalent molecular interactions within PSAC enable efficient recyclability. Consequently, PSAC has the potential to replace high-strength polymer plastics and structural components, providing a promising avenue for developing high-strength and toughness mineral-based structural materials.

The glycerol stabilized calcium phosphate cluster for rapid remineralization of tooth enamel by a water-triggered transformation

Remineralization is a common strategy for the repair of early demineralized tooth enamels, but the harsh dynamic oral environment often hampers its efficacy. Rapid remineralization is expected to address this challenge, however, the stabilizers of remineralization materials often resist their transformation required for repair. Here, by dissolving the ions of calcium and phosphate in glycerol-dominant solvents, we obtain the calcium phosphate clusters (1-2 nm), which are stabilized by glycerol (with high viscosity and affinity to clusters), but can perform a fast enamel repair via the water-triggered transformation in both static and dynamic environments. Upon the in vitro and in vivo (female Sprague-Dawley rats) studies, the clusters swiftly enter the nano-/micro-sized enamel defect sites, then form a compact hydroxyapatite repair layer within a short time (30 min, much faster than the conventional materials), and significantly recovers mechanical properties. This material is promising for large-scale preparation and applications in dental remineralization.

Unraveling the hidden complexity: Exploring dental tissues through single-cell transcriptional profiling

Understanding the composition and function of cells constituting tissues and organs is vital for unraveling biological processes. Single-cell analysis has allowed us to move beyond traditional methods of categorizing cell types. This innovative technology allows the transcriptional and epigenetic profiling of numerous individual cells, leading to significant insights into the development, homeostasis, and pathology of various organs and tissues in both animal models and human samples. In this review, we delve into the outcomes of major investigations using single-cell transcriptomics to decipher the cellular composition of mammalian teeth and periodontal tissues. The recent single-cell transcriptome-based studies have traced in detail the dental epithelium-ameloblast lineage and dental mesenchyme lineages in the mouse incisors and the tooth germ of both mice and humans; unraveled the microenvironment, the identity of niche cells, and cellular intricacies in the dental pulp; shed light on the molecular mechanisms orchestrating root formation; and characterized cellular dynamics of the periodontal ligament. Additionally, cellular components in dental pulps were compared between healthy and carious teeth at a single-cell level. Each section of this review contributes to a comprehensive understanding of tooth biology, offering valuable insights into developmental processes, niche cell identification, and the molecular secrets of the dental environment.

Synthesis and characterization of magnetic nanoparticle-incorporated nanohydroxyapatite and calcium and phosphate ion clusters for biomimetic remineralization of enamel and dentin

Aim

The present study aimed to synthesize and characterize magnetic nanoparticle incorporated nanohydroxyapatite (MNHAP), calcium and phosphate ion clusters (CPICs), and their combination with MNHAP.

Materials and Methods

Nanohydroxyapatite (NHAP), magnetite (Fe3O4), and magnetic nanoparticle-incorporated nanohydroxyapatite (MNHAP) were synthesized using wet precipitation method, co-precipitation method, and ultrasonic-assisted mechanical stirring methods, respectively. CPIC was synthesized by centrifugation method. Their characterizations were analyzed through X-ray diffraction (XRD) crystallography, Fourier-transform infrared spectroscopy (FTIR), vibrating sample magnetometer (VSM), and high-resolution transmission electron microscopy. The biocompatibility of MNHAP was assessed through the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay.

Results

XRD substantiated the presence of diffraction peaks, indicating crystallinity in all synthesized samples. Functional groups in NHAP and MNHAP were confirmed through FTIR analysis. VSM analysis demonstrated superparamagnetic behavior in both MNHAP and Fe3O4. Transmission electron microscope images unveiled the needle-like crystals for NHAP, rod-shaped crystals for MNHAP, and polyhedral shapes for CPIC combined with MNHAP (CPIC + MNHAP). MNHAP exhibited biocompatibility up to 200 µg.

Conclusion

Based on the findings of this study, MNHAP and CPIC + MNHAP may be suitable for the repair of initial caries lesions.

Phosphate Ion-Responsive and Calcium Peroxide-Based Nanomedicine for Bone-Targeted Treatment of Breast Cancer Bone Metastasis

The treatment of breast cancer bone metastasis is an unresolved clinical challenge, mostly because currently therapeutic approaches cannot simultaneously block the tumor growth and repair the osteolytic bone injuries at the metastatic site. Herein, the study develops a novel nanomedicine to treat breast cancer bone metastasis. The nanomedicine is based on phosphate ion-responsive and calcium peroxide-based nanoparticles carrying the bone-targeting agent zoledronic acid on the surface and loaded with the photosensitizer indocyanine green. Following intravenous administration to a mouse model of breast cancer bone metastasis, the nanoparticles efficiently accumulate at the bone metastasis site, react with free phosphate ions, and form hydroxyapatite nanoaggregates and O2, while releasing the photosensitizer. Hydroxyapatite nanoaggregates elicit the remineralization of the collagenous bone matrix and trigger tumor cell apoptosis. Upon irradiating tumor-bearing legs with an 808 nm laser source, the O2 and free photosensitizer produced 1O2 by the reaction of the nanoparticles with phosphate ions, further boosting the anti-tumor effect. Tumor killing hampers the vicious cycle at the site of bone metastasis, translating to osteolysis blockade and further encouraging the remineralization of bone matrix. This work sheds light on the development of a novel, safe, and efficient approach for the treatment of breast cancer bone metastasis.

Promotion effect of proanthocyanidin on dentin remineralization via the polymer induced liquid precursor process

Proanthocyanidin (PA) has demonstrated promise as a dental biomodifier for maintaining dentin collagen integrity, yet there is limited evidence regarding its efficacy in dentin repair. The aim of this study was to investigate the effect of PA on dentin remineralization through the polymer induced liquid precursor (PILP) process, as well as to assess the mechanical properties of the restored dentin. Demineralized dentin was treated with a PA-contained remineralization medium, resulting in the formation of PA-amorphous calcium phosphate (ACP) nanoparticles via the PILP process. The kinetics and microstructure of remineralized dentin were examined through the use of Fourier transform infrared spectroscopy(FTIR), attenuated total reflectance-FTIR, scanning electron microscopy, transmission electron microscopy. The results showed that the application of PA facilitated the process of dentin remineralization, achieving completion within 48 h, demonstrating a notable reduction in time required. Following remineralization, the mechanical properties of the dentin exhibited an elastic modulus of 15.89 ± 1.70 GPa and a hardness of 0.47 ± 0.08 GPa, which were similar to those of natural dentin. These findings suggest that combining PA with the PILP process can promote dentin remineralization and improve its mechanical properties, offering a promising new approach for dentin repair in clinical practice.

In Situ Synthesis and Characterizations of a Strontium-Substituted Dicalcium Phosphate Anhydrous/Hydroxyapatite Biphasic Whisker and Its Properties Evaluation

Dicalcium phosphate anhydrous (DCPA) presents good biomineralization ability, the strontium element is known for superior bone affinity, and a whisker possesses good mechanical strength; all these are beneficial for improving the drawbacks of hydroxyapatite (HAP) like weaker mechanical properties, poor biomineralization, and slower degradation/absorption. Therefore, a homogeneous precipitation was adopted to synthesize Sr-substituted and DCPA and HAP coexisting whiskers. The composition, structure, and morphology based on urea dosage and substitution content were characterized, and the roles of DCPA, Sr, and whisker shape were investigated. It turned out that Sr-DCPA/HAP biphasic products contained about 19% DCPA and 81% HAP, and both phases occupied the outer and inner parts of the whisker, respectively. Increasing the urea dosage made the morphology transform from a sea urchin shape to fiber clusters and then whiskers, while Sr substitution brought the whisker back to the porous microsphere shape. Only 5% of Sr content and 15 g of urea could maintain the whisker shape. Sr could promote the proliferation of MC3T3-E1 cells even at a higher extract concentration of 10 mg/mL. The cells stayed in a healthy state whether cocultured with the whisker or the microsphere. The unstable DCPA combined with the decreased crystallinity brought by Sr doping contributed to shortening the apatite deposition period to within 7 days. The whisker morphology enhanced the compressive strength of acrylic resin, and the apatite layer helped to reduce the strength loss during soaking. The Sr-DCPA/HAP biphasic whisker with enhanced overall properties possessed more promising potential for biomedical application.

A Janus Microsphere Delivery System Orchestrates Immunomodulation and Osteoinduction by Fine-tuning Release Profiles

Bone regeneration is a well-orchestrated process synergistically involving inflammation, angiogenesis, and osteogenesis. Therefore, an effective bone graft should be designed to target multiple molecular events and biological demands during the bone healing process. In this study, a biodegradable gelatin methacryloyl (GelMA)-based Janus microsphere delivery system containing calcium phosphate oligomer (CPO) and bone morphogenetic protein-2 (BMP-2) is developed based on natural biological events. The exceptional adjustability of GelMA facilitates the controlled release and on-demand application of biomolecules, and optimized delivery profiles of CPO and BMP-2 are explored. The sustained release of CPO during the initial healing stages contributes to early immunomodulation and promotes mineralization in the late stage. Meanwhile, the administration of BMP-2 at a relatively high concentration within the therapeutic range enhances the osteoinductive property. This delivery system, with fine-tuned release patterns, induces M2 macrophage polarization and creates a conducive immuno-microenvironment, which in turn facilitates effective bone regeneration in vivo. Collectively, this study proposes a bottom-up concept, aiming to develop a user-friendly and easily controlled delivery system targeting individual biological events, which may offer a new perspective on developing function-optimized biomaterials for clinical use.

Seriation of Enzyme-Functionalized Multilayers for the Design of Scalable Biomimetic Mineralized Structures

Biomimetic hydroxyapatites are widely explored for their potential applications in the repair of mineralized tissues, particularly dental enamel, which is acellular and, thus, not naturally reformed after damage. Enamel is formed with a highly-controlled hierarchical structure, which is difficult to replicate up to the macroscale. A biomimetic approach is thus warranted, based on the same principles that drive biomineralization in vivo. Herein, a strategy for the design of enamel-like architectures is described, utilizing enzymes embedded in polyelectrolyte multilayers to generate inorganic phosphate locally, and provide a favorable chemical environment for the nucleation and growth of minerals. Moreover, a method is proposed to build up seriated mineral layers with scalable thicknesses, continuous mineral growth, and tunable morphology. Results show the outstanding growth of cohesive mineral layers, yielding macroscopic standalone fluoride and/or carbonate-substituted hydroxyapatite materials with comparable crystal structure and composition to native human mineralized tissues. This strategy presents a promising path forward for the biomimetic design of biomineral materials, particularly relevant for restorative applications, with an exquisite level of synthetic control over multiple orders of magnitude.

Dual Nanofillers Reinforced Polymer-Inorganic Nanocomposite Film with Enhanced Mechanical Properties

Simultaneously improving the strength and toughness of polymer-inorganic nanocomposites is highly desirable but remains technically challenging. Herein, a simple yet effective pathway to prepare polymer-inorganic nanocomposite films that exhibit excellent mechanical properties due to their unique composition and structure is demonstrated. Specifically, a series of poly(methacrylic acid)x-block-poly(benzyl methacrylate)y diblock copolymer nano-objects with differing dimensions and morphologies is prepared by polymerization-induced self-assembly (PISA) mediated by reversible addition-fragmentation chain transfer polymerization (RAFT). Such copolymer nano-objects and ultrasmall calcium phosphate oligomers (CPOs) are used as dual fillers for the preparation of polymer-inorganic composite films using sodium carboxymethyl cellulose (CMC) as a matrix. Impressively, the strength and toughness of such composite films are substantially reinforced as high as up to 202.5 ± 14.8 MPa and 62.3 ± 7.9 MJ m-3, respectively. Owing to the intimate interaction between the polymer-inorganic interphases at multiple scales, their mechanical performances are superior to most conventional polymer films and other nanocomposite films. This study demonstrates the combination of polymeric fillers and inorganic fillers to reinforce the mechanical properties of the resultant composite films, providing new insights into the design rules for the construction of novel hybrid films with excellent mechanical performances.

Bottom-Up Assembling Hierarchical Enamel-Like Bulk Materials with Excellent Optical and Mechanical Properties for Tooth Restoration

Enamel has good optical and mechanical properties because of its multiscale hierarchical structure. Biomimetic construction of enamel-like 3D bulk materials at nano-, micro-, mesh- and macro-levels is a challenge. A novel facile, cost-effective, and easy large-scale bottom-up assembly strategy to align 1D hydroxyapatite (HA) nanowires bundles to 3D hierarchical enamel structure with the nanowires bundles layer-by-layer interweaving orientation, is reported. In the strategy, the surface of oleate templated ultralong HA nanowires with a large aspect ratio is functionalized with amphiphilic 10-methacryloyloxydecyl dihydrogen phosphate (MDP). Furtherly, the MDP functionalized HA nanowire bundles are assembled layer-by-layer with oriented fibers in a single layer and cross-locked between layers at a certain angle at mesoscale and macroscale in the viscous bisphenol A-glycidyl methacrylate (Bis-GMA) ethanol solution by shear force induced by simple agitation and high-speed centrifugation. Finally, the excessive Bis-GMA and ethanol are removed, and (Bis-GMA)-(MDP-HA nanowire bundle) matrix is densely packed under hot pressing and polymerized to form bulk enamel-like materials. The composite has superior optical properties and comparable comprehensive mechanic performances through a combination of strength, hardness, toughness, and friction. This method may open new avenues for controlling the nanowires assembly to develop hierarchical nanomaterials with superior properties for many different applications.

Unraveling Nanomaterials in Biomimetic Mineralization of Dental Hard Tissue: Focusing on Advantages, Mechanisms, and Prospects

The demineralization of dental hard tissue imposes considerable health and economic burdens worldwide, but an optimal method that can repair both the chemical composition and complex structures has not been developed. The continuous development of nanotechnology has created new opportunities for the regeneration and repair of dental hard tissue. Increasingly studies have reported that nanomaterials (NMs) can induce and regulate the biomimetic mineralization of dental hard tissue, but few studies have examined how they are involved in the different stages, let alone the relevant mechanisms of action. Besides their nanoscale dimensions and excellent designability, NMs play a corresponding role in the function of the raw materials for mineralization, mineralized microenvironment, mineralization guidance, and the function of mineralized products. This review comprehensively summarizes the advantages of NMs and examines the specific mineralization mechanisms. Design strategies to promote regeneration and repair are summarized according to the application purpose of NMs in the oral cavity, and limitations and development directions in dental hard tissue remineralization are proposed. This review can provide a theoretical basis to understand the interaction between NMs and the remineralization of dental hard tissue, thereby optimizing design strategy, rational development, and clinical application of NMs in the field of remineralization.

Preparation of calcium phosphate ion clusters through atomization method for biomimetic mineralization of enamel

Dental enamel is a mineralized extracellular matrix, and enamel defect is a common oral disease. However, the self-repair capacity of enamel is limited due to the absence of cellular components and organic matter. Efficacy of biomimetic enamel mineralization using calcium phosphate ion clusters (CPICs), is an effective method to compensate for the limited self-healing ability of fully developed enamel. Preparing and stabilizing CPICs presents a significant challenge, as the addition of certain stabilizers can diminish the mechanical properties or biosafety of mineralized enamel. To efficiently and safely repair enamel damage, this study quickly prepared CPICs without stabilizers using the atomization method. The formed CPICs were evenly distributed on the enamel surface, prompting directional growth and transformation of hydroxyapatite (HA) crystals. The study revealed that the mended enamel displayed comparable morphology, chemical composition, hardness, and mechanical properties to those of the original enamel. The approach of repairing dental enamel by utilizing ultrasonic nebulization of CPICs is highly efficient and safe, therefore indicating great promise.

Application of a calcium and phosphorus biomineralization strategy in tooth repair: a systematic review

Biomineralization is a natural process in which organisms regulate the growth of inorganic minerals to form biominerals with unique layered structures, such as bones and teeth, primarily composed of calcium and phosphorus. Tooth decay significantly impacts our daily lives, and the key to tooth regeneration lies in restoring teeth through biomimetic approaches, utilizing mineralization strategies or materials that mimic natural processes. This review delves into the types, properties, and transformations of calcium and phosphorus minerals, followed by an exploration of the mechanisms behind physiological and pathological mineralization in living organisms. It summarizes the mechanisms and commonalities of biomineralization and discusses the advancements in dental biomineralization research, guided by insights into calcium and phosphorus mineral biomineralization. This review concludes by addressing the current challenges and future directions in the field of dental biomimetic mineralization.

Biomimetic Calcium Phosphate Nanoparticles: Biomineralization Models and Precursors for Composite Materials

The formation of calcium phosphate under the control of water-soluble polymers is important for understanding bone growth in living organisms. These experiments also have spin-offs in the creation of composite materials, including for regenerative medicine applications. The formation of calcium phosphate (hydroxyapatite) from calcium chloride and diammonium phosphate was studied in the presence of polymers containing carboxyl, amine, and imidazole groups. Depending on the polymer composition, solid products and stable dispersions of positively or negatively charged nanoparticles were obtained. Oppositely charged nanoparticles can interact with each other to form a macroporous composite material, which holds promise as a filler for bone defects. The formation of a calcium phosphate layer around a living cell (dinoflagellate Gymnodinium corollarium A. M. Sundström, Kremp et Daugbjerg) using positive composite nanoparticles is a one-step approach to cell mineralization.

Enzyme-Activated Biomimetic Vesicles Confining Mineralization for Bone Maturation

Inspired by the crucial role of matrix vesicles (MVs), a series of biomimetic vesicles (BVs) fabricated by calcium glycerophosphate (CaGP) modified polyurethane were designed to mediate the mineralization through in situ enzyme activation for bone therapy. In this study, alkaline phosphatase (ALP) was harbored in the porous BVs by adsorption (Ad-BVs) or entrapment (En-BVs). High encapsulation of ALP on En-BVs was effectively self-activating by calcium ions of CaGP-modified PU that specifically hydrolyzed the organophosphorus (CaGP) to inorganic phosphate, thus promoting the formation of the highly oriented bone-like apatite in vitro. Enzyme-catalyzed kinetics confirms the regulation of apatite crystallization by the synergistic action of self-activated ALP and the confined microcompartments of BVs. This leads to a supersaturated microenvironment, with the En-BVs group exhibiting inorganic phosphate (Pi) levels 4.19 times higher and Ca2+ levels 3.67 times higher than those of simulated body fluid (SBF). Of note, the En-BVs group exhibited excellent osteo-inducing differentiation of BMSCs in vitro and the highest maturity with reduced bone loss in rat femoral defect in vivo. This innovative strategy of biomimetic vesicles is expected to provide valuable insights into the enzyme-activated field of bone therapy.

Phosphorylation of collagen fibrils enhances intrafibrillar mineralization and dentin remineralization

The hierarchical assembly of nanoapatite within a type I collagen matrix was achieved through biomimetic mineralization in vitro, cooperatively regulated by non-collagenous proteins and small biomolecules. Here, we demonstrated that IP6 could significantly promote intrafibrillar mineralization in two- and three-dimensional collagen models through binding to collagen fibrils via hydrogen bonds (the interaction energy ∼10.21 kJ mol-1), as confirmed by the FTIR spectra and isothermal experimental results. In addition, we find that IP6 associated with dental collagen fibrils can also enhance the remineralization of calcium-depleted dentin and restore its mechanical properties similar to the natural dentin within 4 days. The promoting effect is mainly due to the chemical modification of IP6, which alters the interfacial physicochemical properties of collagen fibrils, strengthening the interaction of calcium phosphate minerals and mineral ions with collagen fibrils. This strategy of interfacial regulation to accelerate the mineralization of collagen fibrils is essential for dental repair and the development of a clinical product for the remineralization of hard tissue.

The Synergistic Effect of High Intensity Focused Ultrasound on In-vitro Remineralization of Tooth Enamel by Calcium Phosphate Ion Clusters

Background

Remineralization of dental enamel is an important intervention strategy for the treatment of demineralized lesions. Existing approaches have limitations such as failure to adequately reproduce both the ideal structural and mechanical properties of the native tooth. The ability of ultrasound to control and accelerate the crystallization processes has been widely reported. Therefore, a new approach was explored for in-vitro enamel remineralization involving the synergistic effect of high-intensity focused ultrasound (HIFU) coupled with calcium phosphate ion clusters (CPICs).

Methods

The demineralized enamel was treated with CPICs, with or without subsequent HIFU exposure for different periods (2.5, 5, and 10 min). The specimens were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), and Raman spectroscopy. The surface hardness and crystallographic properties of the treated specimens were evaluated using Vickers microhardness testing and X-ray diffraction (XRD), respectively.

Results

SEM revealed distinct, organized, and well-defined prismatic structures, showing clear evidence of remineralization in the combined CPIC/HIFU treatment groups. AFM further revealed a decrease in the surface roughness values with increasing HIFU exposure time up to 5 min, reflecting the obliteration of interprismatic spaces created during demineralization. The characteristic Raman band at 960 cm-1 associated with the inorganic phase of enamel dominated well in the HIFU-treated specimens. Importantly, microhardness testing further demonstrated that new mineral growth also recovered the mechanical properties of the enamel in the HIFU-exposed groups. Critical to our aspirations for developing this into a clinical process, these results were achieved in only 5 min.

Conclusion

HIFU exposure can synergise and significantly accelerate in-vitro enamel remineralization process via calcium phosphate ion clusters. Therefore, this synergistic approach has the potential for use in future clinical interventions.

Biomineral-Based Composite Materials in Regenerative Medicine

Regenerative medicine aims to address substantial defects by amplifying the body's natural regenerative abilities and preserving the health of tissues and organs. To achieve these goals, materials that can provide the spatial and biological support for cell proliferation and differentiation, as well as the micro-environment essential for the intended tissue, are needed. Scaffolds such as polymers and metallic materials provide three-dimensional structures for cells to attach to and grow in defects. These materials have limitations in terms of mechanical properties or biocompatibility. In contrast, biominerals are formed by living organisms through biomineralization, which also includes minerals created by replicating this process. Incorporating biominerals into conventional materials allows for enhanced strength, durability, and biocompatibility. Specifically, biominerals can improve the bond between the implant and tissue by mimicking the micro-environment. This enhances cell differentiation and tissue regeneration. Furthermore, biomineral composites have wound healing and antimicrobial properties, which can aid in wound repair. Additionally, biominerals can be engineered as drug carriers, which can efficiently deliver drugs to their intended targets, minimizing side effects and increasing therapeutic efficacy. This article examines the role of biominerals and their composite materials in regenerative medicine applications and discusses their properties, synthesis methods, and potential uses.

Guidelines derived from biomineralized tissues for design and construction of high-performance biomimetic materials: from weak to strong

Living organisms in nature have undergone continuous evolution over billions of years, resulting in the formation of high-performance fracture-resistant biomineralized tissues such as bones and teeth to fulfill mechanical and biological functions, despite the fact that most inorganic biominerals that constitute biomineralized tissues are weak and brittle. During the long-period evolution process, nature has evolved a number of highly effective and smart strategies to design chemical compositions and structures of biomineralized tissues to enable superior properties and to adapt to surrounding environments. Most biomineralized tissues have hierarchically ordered structures consisting of very small building blocks on the nanometer scale (nanoparticles, nanofibers or nanoflakes) to reduce the inherent weaknesses and brittleness of corresponding inorganic biominerals, to prevent crack initiation and propagation, and to allow high defect tolerance. The bioinspired principles derived from biomineralized tissues are indispensable for designing and constructing high-performance biomimetic materials. In recent years, a large number of high-performance biomimetic materials have been prepared based on these bioinspired principles with a large volume of literature covering this topic. Therefore, a timely and comprehensive review on this hot topic is highly important and contributes to the future development of this rapidly evolving research field. This review article aims to be comprehensive, authoritative, and critical with wide general interest to the science community, summarizing recent advances in revealing the formation processes, composition, and structures of biomineralized tissues, providing in-depth insights into guidelines derived from biomineralized tissues for the design and construction of high-performance biomimetic materials, and discussing recent progress, current research trends, key problems, future main research directions and challenges, and future perspectives in this exciting and rapidly evolving research field.

Construction of Mineralization Nanostructures in Polymers for Mechanical Enhancement and Functionalization

Mineralization capable of growing inorganic nanostructures efficiently, orderly, and spontaneously shows great potential for application in the construction of high-performance organic-inorganic composites. As a thermodynamically spontaneous solid-phase crystallization reaction involving dual organic and inorganic components, mineralization allows for the self-assembly of sophisticated and exclusive nanostructures within a polymer matrix. It results in a diversity of functions such as enhanced strength, toughness, electrical conductivity, selective permeability, and biocompatibility. While there are previous reviews discussing the progress of mineralization reactions, many of them overlook the significant benefits of interfacial regulation and functionalization that come from the incorporation of mineralized structures into polymers. Focusing on different means of assembly of mineralized nanostructures in polymer, the work analyzes their design principles and implementation strategies. Then, their different advantages and disadvantages are analyzed by combining nanostructures with organic substrates as well as involving the basis of different functionalizations. It is anticipated to provide insights and guidance for the future development of mineralized polymer composites and their application designs.

Rapid Deposition of the Biomimetic Hydroxyapatite-Polydopamine-Amino Acid Composite Layers onto the Natural Enamel

In this work, we developed a technology that enables rapid deposition of biomimetic composite films onto natural enamel slices (known as biotemplates). These films are composed of polydopamine (PDA) and nanocrystalline carbonate-substituted hydroxyapatite (nano-cHAp) that have been functionalized with amino acid l-Arginine. We utilized atomic force microscopy (AFM) and scattering scanning near-field optical microscopy (s-SNOM) combined with infrared (IR) synchrotron to achieve nanoscale spatial resolution for both IR absorption and topography analyses. This combined analytical modality allowed us to understand how morphology connects to local changes in the chemical environment on the biotemplate surface during the deposition of the bioinspired coating. Our findings revealed that when using the proposed technology and after the deposition of the first PDA layer, the film formed on the enamel surface nearly covers the entire surface of the specimen whose thickness is larger on the surface of the emerging enamel prisms. Calculation of the crystallinity index for the biomimetic layer showed a multiple increase compared with natural enamel. This indicates regular and dense aggregation of nano-cHAp into larger crystals, imitating the morphology of natural enamel rods. The microhardness of the formed PDA-based biomimetic layer mineralized with nano-cHAp functionalized with amino acid l-Arginine deposited on natural enamel was practically the same as that of natural enamel. The characterization of nano-cHAp-amino acid-PDA layers using IR and Raman microspectroscopy showed that l-arginine acts as a conjunction agent in the formation of mineralized biomimetic composite coatings. The uniformity of the mechanisms of PDA layer formation under different deposition conditions and substrate types allows for the formation of coatings regardless of the macro- and micromorphology of the template. Therefore, the results obtained in this work have a high potential for future clinical applications in dental practice.

Biomimetic Self-Maturation Mineralization System for Enamel Repair

Enamel repair is crucial for restoring tooth function and halting dental caries. However, contemporary research often overlooks the retention of organic residues within the repair layer, which hinders the growth of dense crystals and compromises the properties of the repaired enamel. During the maturation of natural enamel, the organic matrix undergoes enzymatic processing to facilitate further crystal growth, resulting in a highly mineralized tissue. Inspired by this process, a biomimetic self-maturation mineralization system is developed, comprising ribonucleic acid-stabilized amorphous calcium phosphate (RNA-ACP) and ribonuclease (RNase). The RNA-ACP induces initial mineralization in the form of epitaxial crystal growth, while the RNase present in saliva automatically triggers a biomimetic self-maturation process. The mechanistic study further indicates that RNA degradation prompts conformational rearrangement of the RNA-ACP, effectively excluding the organic matter introduced earlier. This exclusion process promotes lateral crystal growth, resulting in the generation of denser enamel-like apatite crystals that are devoid of organic residues. This strategy of eliminating organic residues from enamel crystals enhances the mechanical and physiochemical properties of the repaired enamel. The present study introduces a conceptual biomimetic mineralization strategy for effective enamel repair in clinical practice and offers potential insights into the mechanisms of biomineral formation.

Amorphous 1-D nanowires of calcium phosphate/pyrophosphate: A demonstration of oriented self-growth of amorphous minerals

Amorphous inorganic solids are traditionally isotropic, thus, it is believed that they only grow in a non-preferential way without the assistance of regulators, leading to the morphologies of nanospheres or irregular aggregates of nanoparticles. However, in the presence of (ortho)phosphate (Pi) and pyrophosphate ions (PPi) which have synergistic roles in biomineralization, the highly elongated amorphous nanowires (denoted ACPPNs) form in a regulator-free aqueous solution (without templates, additives, organics, etc). Based on thorough characterization and tracking of the formation process (e.g., Cryo-TEM, spherical aberration correction high resolution TEM, solid state NMR, high energy resolution monochromated STEM-EELS), the microstructure and its preferential growth behavior are elucidated. In ACPPNs, amorphous calcium orthophosphate and amorphous calcium pyrophosphate are distributed at separated but close sites. The ACPPNs grow via either the preferential attachment of ∼2 nm nanoclusters in a 1-dimension way, or the transformation of bigger nanoparticles, indicating an inherent driving force-governed process. We propose that the anisotropy of ACPPNs microstructure, which is corroborated experimentally, causes their oriented growth. This study proves that, unlike the conventional view, amorphous minerals can form via oriented growth without external regulation, demonstrating a novel insight into the structures and growth behaviors of amorphous minerals.

Tubular Nanoclay-Enhanced Calcium Phosphate Mineralization and Assembly to Impart High Stiffness and Antimicrobial Properties

Achieving superior mechanical properties of composite materials in artificially engineered materials is a great challenge due to technical bottlenecks in the size and morphological modulation of inorganic nanominerals. Hence, a "bioprocess-inspired fabrication" is proposed to create multilayered organic-inorganic columnar structures. The sequential assembly of halloysite nanotubes (HNTs), polyelectrolytes (PAAs), and calcium phosphates (CaPs) results in organic-inorganic structures. PAA plays a crucial role in controlling the formation of CaP, guiding it into amorphous particles with smaller nanosizes. The introduction of HNT induces the assembly and maturation of CaP-PAA, leading to the formation of a highly crystalline hydroxyapatite. Poly(vinyl alcohol) was then woven into HNT-encapsulated hydroxyapatite nanorods, resulting in composite materials with basic hierarchical structures across multiple scales. The fabricated composite exhibits exceptional hardness (4.27 ± 0.33 GPa) and flexural strength (101.25 ± 1.72 MPa), surpassing those of most previously developed biological hard tissue materials. Additionally, the composite demonstrates effective antibacterial properties and corrosion resistance, attributed to the dense crystalline phase of CaP. This innovative approach showcases the potential of clay minerals, particularly HNT, in the advancement of biomaterial design. The outstanding mechanical and antimicrobial properties of clay-based composites make them a promising candidate for applications in hard tissue repair, offering versatility in biomedicine and engineering.

Effects of different patterns of movement for correcting a deep curve of Spee with clear aligners on the anterior teeth: a finite element analysis

OBJECTIVE

To analyse the anterior teeth effects of clear aligners on five different patterns of mandibular molar movement and to define the most effective configuration to be implemented with clear aligners through finite element analysis.

METHODS

A three-dimensional mandibular model with a deep overbite in the mandible was constructed using cone beam computerized tomography (CBCT) data. The model included the mandibular dentition, mandibular periodontal ligaments, attachments, and aligners. Five models were created: (1) configuration A: second molar distalization (0.25 mm); (2) configuration B: second molar distalization (0.25 mm), first molar extrusion (0.15 mm); (3) configuration C: second molar distalization (0.25 mmm), first and second premolar extrusion(0.15 mm); (4) configuration D: second molar distalization (0.25 mm), first molar and first/second premolar extrusion(0.15 mm); and (5) configuration E: second molar distalization (0.25 mm), first molar and first/second premolar extrusion (0.15 mm), first molar and first/second premolar expansion (0.15 mm).

RESULTS

In all configurations, the anterior teeth exhibited labial tipping and the mandibular central incisor of configuration E showed the highest labial tipping. Configuration E demonstrated a relatively minor impact on mandibular molars distalization compared with configuration A. Configuration A showed the highest distal displacement value, and configuration E produced the lowest displacement value. Configuration E caused the highest periodontal ligament (PDL) pressure of the central and lateral incisors. The differences in the canines between configurations C and D,were not significant, and the stress distribution differed among the five groups.

CONCLUSIONS

All patterns utilizing clear aligners facilitated mandibular molar distalization. Extruding the premolars and second molar distalization at the same time had little impact on second molar distalization; When expansion and extrusion were simultaneously performed during the distalization of mandibular molars, our prime consideration was the alveolar bone on the labial side of the anterior teeth to prevent the occurrence of gingival recession, dehiscence, and fenestration. Due to the lack of consideration for periodontal tissues in this study, clinical protocols should be designed based on the periodontal status of the mandibular anterior teeth.

Bioinspired Organic Porous Coupling Agent for Enhancement of Nanoparticle Dispersion and Interfacial Strength

Composite materials have significantly advanced with the integration of inorganic nanoparticles as fillers in polymers. Achieving fine dispersion of these nanoparticles within the composites, however, remains a challenge. This study presents a novel solution inspired by the natural structure of Xanthium. We have developed a polymer of intrinsic microporosity (PIM)-based porous coupling agent, named PCA. PCA's rigid backbone structure enhances interfacial interactions through a unique intermolecular interlocking mechanism. This approach notably improves the dispersion of SiO2 nanoparticles in various organic solvents and low-polarity polymers. Significantly, PCA-modified SiO2 nanoparticles embedded in polyisoprene rubber showed enhanced mechanical properties. The Young's modulus increases to 30.7 MPa, compared to 5.4 MPa in hexadecyltrimethoxysilane-modified nanoparticles. Further analysis shows that PCA-modified composites not only become stiffer but also gain strength and ductility. This research demonstrates a novel biomimetic strategy for enhancing interfacial interactions in composites, potentially leading to stronger, more versatile composite materials.

Development of nanobiosilicate, tricalcium phosphate and chlorhexidine materials for biomineralization with crystallographic similarity to hydroxyapatite and biomodified collagen

OBJECTIVES

The aim of this work is to test experimental cements, doped with a silicate based bioactive nanoparticle (NanoBiosilicate). Methods, we synthesized a glass nanoparticle by Sol-Gel Stöber method, used to be incorporated in a dental material for endodontic uses.

MATERIALS AND METHODS

We assess the mineralizing properties and biocompatibility. Besides the crystallography characterization of the resultant new crystals. Results, After analysis, and comparison with commercial materials, the material tested was similar in mechanical properties required by ISO, The ion release was effective after 2 hr. of setting and the novel material was cell compatible accepted by ISO.

RESULTS

We found new formed Calcium Phosphate peaks in the spectroscopic analysis (FTIR), remarkably the crystals formed were comparable to hydroxyapatite when analyzed with a Selected Area Electron Diffractometer, with rings of 2.84 Å for 002, and the 2.77 Å is also visible for 210. The 6.83 Å and 6.88 Å, for respective 222 and 004. The incorporation of Chlorhexidine was not detrimental for this property, Significance, the features mentioned represented a progress in biomineralization field that was associated to an improved mineral structure formation with increased crystallographic similarity to natural hydroxyapatite. When chlorhexidine was added a favorable biomodification of the remaining collagen in dentinal walls and antimicrobial activity potential were also observed.

Bio-inspired nacre-like zirconia/PMMA composites for chairside CAD/CAM dental restorations

OBJECTIVES

To introduce a versatile fabrication process to fabricate zirconia/PMMA composites for chairside CAD/CAM dental restorations. These zirconia composites have nacre-like lamellar microstructures, competent and tooth-matched mechanical properties, as well as crack resistance behaviours.

METHODS

Bi-directional freeze casting was used to fabricate ceramic green bodies with highly aligned lamellar structure. Pressure was then applied to control the ceramic volume fraction. PMMA was infiltrated into the ceramic scaffold. Mechanical tests including 3-point bending, Vickers hardness, and fracture toughness were performed on the composites. The machinability of the composites was also characterised.

RESULTS

Two types of nacre-like zirconia/PMMA composites, i.e., 3Y-YZP/PMMA and 5Y-PSZ/PMMA composites were fabricated. The microstructure created was similar to the 'brick and mortar' structure of nacre. Excellent flexural strength (up to 400 MPa and 290 MPa for 3Y-TZP/PMMA and 5Y-PSZ/PMMA composite, respectively), tuneable hardness and elastic modulus within the range similar to enamel, along with improved crack-resistance behaviour were demonstrated on both zirconia composites. In addition, both zirconia/PMMA composites showed acceptable machinability, being easy to mill, as would be required to produce a dental crown.

SIGNIFICANCE

Nacre-like zirconia/PMMA composites therefore exhibit the potential for use in the production of chairside CAD/CAM dental restorations.

Design and synthesis of bioinspired nanomaterials for biomedical application

Natural materials and bioprocesses provide abundant inspirations for the design and synthesis of high-performance nanomaterials. In the past several decades, bioinspired nanomaterials have shown great potential in the application of biomedical fields, such as tissue engineering, drug delivery, and cancer therapy, and so on. In this review, three types of bioinspired strategies for biomedical nanomaterials, that is, inspired by the natural structures, biomolecules, and bioprocesses, are mainly introduced. We summarize and discuss the design concepts and synthesis approaches of various bioinspired nanomaterials along with their specific roles in biomedical applications. Additionally, we discuss the challenges for the development of bioinspired biomedical nanomaterials, such as mechanical failure in wet environment, limitation in scale-up fabrication, and lack of deep understanding of biological properties. It is expected that the development and clinical translation of bioinspired biomedical nanomaterials will be further promoted under the cooperation of interdisciplinary subjects in future. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Emerging Technologies.

Nacre-like ceramic composites: Properties, functions and fabrication in the context of dental restorations

Dental restorations are in increasing demand, yet their success rate strongly decreases after 5-10 years post-implantation, attributed in part to mismatching properties with the surrounding buccal environment that causes failures and wear. Among current research to address this issue, biomimetic approaches are promising. Nacre-like ceramic composites are particularly interesting because they combine multiple antagonistic properties making them more resistant to failure in harsh environment than other materials. With the rapid progress in 3D printing producing nacre-like structures has open up new opportunities not yet realised. In this paper, nacre-like composites of various compositions are reviewed in the context of hypothetical biomimetic dental restorations. Their structural, functional and biological properties are compared with those of dentin, enamel, and bone to determine which composition would be the most suitable for each of the 3 mineralized regions found in teeth. The role of complex microstructures and mineral orientations are discussed as well as 3D printing methods that allow the design and fabrication of such complex architectures. Finally, usage of these processes and anticipated prospects for next generation biomimetic dental replacements are discussed to suggest future research directions in this area. STATEMENT OF SIGNIFICANCE: With the current ageing population, dental health is a major issue and current dental restorations still have shortcomings. For the next generation of dental restorations, more biomimetic approaches would be desirable to increase their durability. Among current materials, nacre-like ceramic composites are interesting because they can approach the various structural properties found in the different parts of our teeth. Furthermore, it is also possible to embed self-sensing functionalities to enable monitoring of oral health. Finally, new recent 3D printing technologies now permit the fabrication of complex shapes with local compositions and local microstructures. With this current status of the research, we anticipate new dental restorations designs and highlight the remaining gaps and issues to address.

Research progress of biomimetic materials in oral medicine

Biomimetic materials are able to mimic the structure and functional properties of native tissues especially natural oral tissues. They have attracted growing attention for their potential to achieve configurable and functional reconstruction in oral medicine. Though tremendous progress has been made regarding biomimetic materials, significant challenges still remain in terms of controversy on the mechanism of tooth tissue regeneration, lack of options for manufacturing such materials and insufficiency of in vivo experimental tests in related fields. In this review, the biomimetic materials used in oral medicine are summarized systematically, including tooth defect, tooth loss, periodontal diseases and maxillofacial bone defect. Various theoretical foundations of biomimetic materials research are reviewed, introducing the current and pertinent results. The benefits and limitations of these materials are summed up at the same time. Finally, challenges and potential of this field are discussed. This review provides the framework and support for further research in addition to giving a generally novel and fundamental basis for the utilization of biomimetic materials in the future.

Treatment Approaches to Molar Incisor Hypomineralization: A Systematic Review

AIM

This systematic review aimed to comprehensively evaluate the available literature on treating molar incisor hypomineralization (MIH) or enamel hypomineralization published between 2013 and 2023, focusing on identifying relevant studies and their characteristics.

MATERIALS AND METHODS

The search process encompassed reputable academic databases, including PubMed, Scopus, Cochrane Library, and Web of Science, using a precise keyword strategy ("((molar incisor hypomineralization) OR (enamel hypomineralization)) AND (treatment)"). A total of 637 articles were initially retrieved, followed by a strict selection process adhering to PRISMA guidelines. The inclusion criteria encompassed Randomized Control Trials (RCTs), case series with more than five clinical cases (CSs), studies involving human participants, availability as free full-text or accessible with university credentials, and English-language publications. Exclusion criteria included systematic or literature reviews, editorials, single-case reports, studies conducted in vitro, those involving animals, paid articles, and non-English-language publications.

RESULTS

The search yielded 864 articles, of which 23 met the stringent inclusion criteria after a meticulous selection process. These studies will serve as the basis for a comprehensive analysis of MIH treatment approaches. The systematic review ensures the quality and relevance of the chosen studies for a detailed assessment of MIH treatment strategies.

CONCLUSIONS

This systematic review will provide valuable insights into the characteristics of selected studies, patient profiles, and available treatment options for molar incisor hypomineralization, contributing to a better understanding of this dental condition's management.

Biomineralization of calcium phosphates functionalized with hydroxyapatite-binding peptide

Functionalization of calcium phosphates with biomimetic peptides is a promising strategy to increase cellular response for bone tissue repair. In this work, biphasic calcium phosphate pellets were functionalized with the hydroxyapatite-binding peptide pVTK by dropping a suspension of the peptide on the pellet surface. The bioactivity tests were performed in vitro by using McCoy culture medium. Cytotoxicity tests were also performed to assess cell viability. The material was characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy with field emission gun (FEG-SEM). The results showed that functionalization with the biomimetic peptide was most effective in inducing precipitation of bone-like apatite on the pellets surface, when compared to the control groups (two positive control groups and one negative control group). Cytotoxicity tests showed that all samples are biocompatible but the pellets with peptide showed the highest values of cell viability.

Restorative Dental Resin Functionalized with Calcium Methacrylate with a Hydroxyapatite Remineralization Capacity

The ability of dental materials to induce the mineralization of enamel like hydroxyapatite (HA) is of great importance. In this article, a novel kind of dental restorative material characterized by a mineralization ability was fabricated by photopolymerization. Calcium methacrylate (CMA) was introduced into the classical bisphenol A-glycidyl methacrylate (Bis-GMA) and triethylene glycol dimethacrylate (TEGDMA) dental resin formulation. This functional dental resin (BTCM) was calcium-rich and can be prepared simply by one-step photopolymerization. The influence of CMA on the photopolymerization kinetics, the dental resin's mechanical properties, and its capacity to induce dynamic in situ HA mineralization were examined. Real-time FTIR, compression modulus, scanning electron microscopy, X-ray spectroscopy, MTT assay, and cell attachment test were carried out. The obtained data were analyzed for statistical significance using analysis of variance (ANOVA). Double bond conversion could be completed in less than 300 s, while the compression modulus of BTCM decreased with the increase in CMA content (30 wt%, 40 wt%, and 50 wt%). After being soaked in Ca(NO3)2 and Na2HPO4 solutions alternatively, dense HA crystals were found on the surface of the dental resin which contained CMA. The amount of HA increased with the increase in CMA content. The MTT results indicated that BTCM possesses good biocompatibility, while the cell adhesion and proliferation investigation demonstrated that L929 cells can adhere and proliferate well on the surface of BTM. Thus, our approach provides a straightforward, cost-effective, and environmentally friendly solution that has the potential for immediate clinical use.

Bio-Inspired Nanomaterials for Micro/Nanodevices: A New Era in Biomedical Applications

Exploring bio-inspired nanomaterials (BINMs) and incorporating them into micro/nanodevices represent a significant development in biomedical applications. Nanomaterials, engineered to imitate biological structures and processes, exhibit distinctive attributes such as exceptional biocompatibility, multifunctionality, and unparalleled versatility. The utilization of BINMs demonstrates significant potential in diverse domains of biomedical micro/nanodevices, encompassing biosensors, targeted drug delivery systems, and advanced tissue engineering constructs. This article thoroughly examines the development and distinctive attributes of various BINMs, including those originating from proteins, DNA, and biomimetic polymers. Significant attention is directed toward incorporating these entities into micro/nanodevices and the subsequent biomedical ramifications that arise. This review explores biomimicry's structure-function correlations. Synthesis mosaics include bioprocesses, biomolecules, and natural structures. These nanomaterials' interfaces use biomimetic functionalization and geometric adaptations, transforming drug delivery, nanobiosensing, bio-inspired organ-on-chip systems, cancer-on-chip models, wound healing dressing mats, and antimicrobial surfaces. It provides an in-depth analysis of the existing challenges and proposes prospective strategies to improve the efficiency, performance, and reliability of these devices. Furthermore, this study offers a forward-thinking viewpoint highlighting potential avenues for future exploration and advancement. The objective is to effectively utilize and maximize the application of BINMs in the progression of biomedical micro/nanodevices, thereby propelling this rapidly developing field toward its promising future.

Biomimetic Mineralization: From Microscopic to Macroscopic Materials and Their Biomedical Applications

Biomineralization is an attractive pathway to produce mineral-based biomaterials with high performance and hierarchical structures. To date, the biomineralization process and mechanism have been extensively studied, especially for the formation of bone, teeth, and nacre. Inspired by those, abundant biomimetic mineralized materials have been fabricated for biomedical applications. Those bioinspired materials generally exhibit great mechanical properties and biological functions. Nevertheless, substantial gaps remain between biomimetic materials and natural materials, particularly with respect to mechanical properties and mutiscale structures. This Review summarizes the recent progress of micro- and macroscopic biomimetic mineralization from the perspective of materials synthesis and biomedical applications. To begin with, we discuss the progress of biomimetic mineralization at the microscopic level. The mechanical strength, stability, and functionality of the nano- and micromaterials are significantly improved by introducing biominerals, such as DNA nanostructures, nanovaccines, and living cells. Next, numerous biomimetic strategies based on biomineralization at the macroscopic scale are highlighted, including in situ mineralization and bottom-up assembly of mineralized building blocks. Finally, challenges and future perspectives regarding the development of biomimetic mineralization are also presented with the aim of offering insights for the rational design and fabrication of next-generation biomimetic mineralized materials.

The effect of calcium phosphate ion clusters in enhancing enamel conditions versus Duraphat and Icon

This study aimed to evaluate and compare the remineralisation, mechanical, anti-aging, acid resistance and antibacterial properties of calcium phosphate ion clusters (CPICs) materials with those of Duraphat and Icon. The remineralisation and mechanical properties were investigated using scanning electron microscopy, Fourier-transform infrared (FTIR) spectroscopy and nanoindentation. CPICs induced epitaxial crystal growth on the enamel surface, where the regrown enamel-like apatite layers had a similar hardness and elastic modulus to natural enamel (p > 0.05). Acid resistance and anti-aging properties were tested based on ion dissolution and surface roughness. CPICs exhibited similar calcium and phosphate ion dissolution to the control (p > 0.05), and its roughness decreased after thermocycling (p < 0.05), thereby decreasing the risk of enamel surface demineralisation. The minimum inhibitory concentration was 0.1 mg/ml, and the minimum bactericidal concentration ranged from 0.05 to 0.1 mg/ml. Overall, this biomimetic CPICs is a promising alternative to dental demineralisation.

Photosynthesis-Mediated Intracellular Biomineralization of Gold Nanoparticles inside Chlorella Cells towards Hydrogen Boosting under Green Light

Engineering living microorganisms to enhance green biomanufacturing for the development of sustainable and carbon-neutral energy strategies has attracted the interest of researchers from a wide range of scientific communities. In this study, we develop a method to achieve photosynthesis-mediated biomineralization of gold nanoparticles (AuNPs) inside Chlorella cells, where the photosynthesis-dominated reduction of Au3+ to Au0 allows the formed AuNPs to locate preferentially around the thylakoid membrane domain. In particular, we reveal that the electrons generated by the localized surface plasmon resonance of AuNPs could greatly augment hypoxic photosynthesis, which then promotes the generation and transferring of photoelectrons throughout the photosynthetic chain for augmented hydrogen production under sunlight. We demonstrate that the electrons from AuNPs could be directly transferred to hydrogenase, giving rise to an 8.3-fold enhancement of Chlorella cells hydrogen production independent of the cellular photosynthetic process under monochromatic 560 nm light irradiation. Overall, the photosynthesis-mediated intracellular biomineralization of AuNPs could contribute to a novel paradigm for functionalizing Chlorella cells to augment biomanufacturing.

An epigallocatechin gallate-amorphous calcium phosphate nanocomposite for caries prevention and demineralized enamel restoration

Biomineralization with amorphous calcium phosphate (ACP) is a highly effective strategy for caries prevention and defect restoration. The identification and interruption of cariogenic biofilm formation during remineralization remains a challenge in current practice. In this study, an epigallocatechin gallate (EGCG)-ACP functional nanocomposite was developed to prevent and restore demineralization by integrating the antibacterial property of EGCG and the remineralization effect of ACP. The synthesized EGCG-ACP showed good biocompatibility with L-929 ​cells and human gingival fibroblasts. Under neutral conditions, the sustained release of ACP from EGCG-ACP restored the microstructure and mechanical properties of demineralized enamel. Under acidic conditions, protonated EGCG released from EGCG-ACP exerted a strong antibacterial effect, and the ACP release rate doubled within 4 ​h, resulting in the prevention of demineralization in the presence of cariogenic bacteria. The pH-responsive features of EGCG-ACP to promote the protonation of EGCG and ACP release facilitated its performance in remineralization effect to overcome the difficulty of restoring demineralized enamel in a cariogenic acidic environment, which was evidenced by the in vivo experiment carried out in a rat oral cariogenic environment. The results of this study indicate the potential of EGCG-ACP for the prevention of enamel demineralization and provide a theoretical basis its application in populations with high caries risk.

The Effect of Biomimetic Remineralization of Calcium Phosphate Ion Clusters-Treated Enamel Surfaces on Bracket Shear Bond Strength

Purpose

To evaluate the remineralization effect of calcium phosphate ion clusters (CPICs) on demineralized enamel surfaces and their effects on bracket shear bond strength.

Patients and Methods

Extracted premolars were prepared in resin blocks. The samples in the form of resin blocks were divided into five experimental groups: control group, demineralized group, and groups of CPIC solution treatment for 30, 60, and 90s. The specimens were examined using scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDX), microhardness testing, micro-computed tomography (micro-CT) assessment, shear bond strength (SBS) test, and adhesive remnant index (ARI) score.

Results

The SEM images revealed epitaxial growth of enamel and a decrease in the thickness of the demineralized enamel layer when treated with CPIC solution. The EDX analysis revealed an increase in the Ca/P ratio in the CPIC-treated groups. The microhardness value significantly increased when treated with CPICs; however, it showed a lower value than that of the sound enamel groups. As a result of the micro-CT test, radiolucency decreased gradually as the CPIC treatment time increased. The SBS test and ARI score results showed an improvement in bonding stability after treatment with CPICs.

Conclusion

We demonstrated an enamel biomodification approach using CPIC solution treatment, which is a promising strategy for enamel remineralization. Specifically, remineralization of demineralized enamel improves the orthodontic bracket SBS.