Amyloid-Mediated Remineralization in Pit and Fissure for Caries Preventive Therapy

The pits and fissures of teeth have high caries susceptibility, and sealing these areas is considered as an effective method to prevent caries. However, long-term caries prophylaxis cannot be maintained because of the negative effects derived from the technical sensitivity and disadvantages of sealing materials. Herein, a new strategy is proposed to occlude fossae by amyloid-mediated biomimetic remineralization. In contrast to conventional inward blocking from the outside of fossae, amyloid-mediated biomimetic mineralization delivers an amyloid-like protein nanofilm into the deepest zone of the fossae and induces the formation of remineralized enamel inside. Such assembly from lysozyme conjugated with poly (ethylene glycol) enriches the interface with strongly bonded ionsand directs in situ nucleation to achieve enamel epitaxial growth. Not only is the structure of the enamel-like crystalline hydroxyapatite layer but also its mechanical stability is similar to that of natural enamel. Furthermore, the layer shows good biocompatibility and antibacterial properties. On the basis of the findings, it is demonstrated that amyloid-like protein aggregation may provide an enamel remineralization strategy to modify the current clinically available methods of pit and fissure sealing and shows great promise in preventing caries.

[Consensus resolution on a modern view on the therapeutic and prophylactic effect of individual oral care products containing fluoride]

The purpose of the publication was to present the materials of the Expert Council Consensus on 'A Modern View on the Treatment and Preventive Effect of Fluoride Containing Personal Oral Care Products', which took place on April 21, 2019 in Moscow (Russia) with the support of the pharmaceutical company JSC GlaskoSmitKlein Helsker. During the work of the expert council, a solution was developed for the safe use of fluoride-containing oral hygiene products as part of fluoride prevention of dental caries. In the real conditions of everyday life, it is advisable for dentists to: use local fluoride-containing agents to know the concentration of fluoride in drinking water and in areas with low and optimal levels of it; recommend fluorides for daily use in small concentrations, for example, for children from 2 years of age to brush their teeth twice a day with fluoride toothpaste for at least 3 minutes; children up to 6 years old, when brushing their teeth once, use no more than a pea-size piece of toothpaste with 500 ppm of fluoride; toothpastes with fluoride concentration from 500 to 5000 ppm should be admitted depending on the risk level of caries development; rinses with a fluoride concentration of 0.025-0.05% should be recommended for children from 6 years and adults twice a day for 1 minute after brushing teeth; for patients with a high risk of caries, periodically (from 2 to 6 times a year) to carry out applications with agents with high concentration of fluorides; for prolonging the effect of local fluorine-containing agents advise patients to refrain from eating and drinking for an hour after their use. Dentists should know the methods of fluoride use in dentistry, since fluoride prevention of caries should be an integral part of their therapeutic and preventive work.