Jones Nathan A, Pan Li-Chi, Flannagan Susan E, Jones Kai A, Lukashova Lyudmila, Wightman Lucas, Chang Sywe-Ren, Jones Glenn, Tenuta Livia M A, González-Cabezas Carlos, Clarkson Brian H, Bloembergen Wendy, Bloembergen Steven
GreenMark Biomedical Inc, East Lansing and Ann Arbor, MI.
School of Dentistry, University of Michigan, Ann Arbor, MI.
JADA Found Sci. 2024;3. doi: 10.1016/j.jfscie.2024.100041. Epub 2024 Nov 20.
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.
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.
In aqueous suspension and absent amylase, particles showed sustained mineral ion release. The tomographic evaluation found significant (multivariable regression analysis, < .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, < .05 for MLCS-FF [75.4%], MLCS-FP [75.7%], fluoride [64.1%] vs negative control [-0.2%]) were observed.
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.
非侵入性龋病治疗通过局部作用发挥功效，这可能会限制其疗效。作者推测，采用旨在靶向非龋洞性龋损病变表层下区域的载矿物质颗粒的替代方法可能具有优势。本研究展示了体外概念验证。
制备了载矿物质阳离子淀粉（MLCS）颗粒，包含钙、磷酸盐和氟化物，以提供含氟加（FP）和无氟（FF）的替代物。对颗粒进行了矿物质负载和释放特性分析。在含有淀粉酶和酸刺激的人工唾液中浸泡20天的方案后，对天然光滑面龋损病变（每组n = 15）评估MLCS - FP和 - FF处理组与1000 ppm氟化物和去离子水对照组。通过微型计算机断层扫描、标记荧光成像和盲法定性视觉评估来评估治疗效果。
在水悬浮液且无淀粉酶的情况下，颗粒显示出持续的矿物质离子释放。断层扫描评估发现，与氟化物和阴性对照组（分别为7.4%和 - 18%）相比，MLCS - FP和MLCS - FF显著（多变量回归分析，P <.05）恢复了病变矿物质密度（分别为42.9%和38.6%），特别是对于病变表层下区域（对于0.25至0.45μm病变深度，FP、FF、氟化物和去离子水的相对羟基磷灰石密度分别为13.8% [13.0%]、15.9% [9.4%]、 - 2.2% [7.3%]和 - 1.8% [4.0%]）。在视觉上观察到白色不透明度降低（Fisher精确检验，P = 0.038，MLCS - FF与氟化物相比）以及标记荧光降低（方差分析，MLCS - FF [75.4%]、MLCS - FP [75.7%]、氟化物 [64.1%]与阴性对照 [- 0.2%]相比，P <.05）。
这些基础研究表明，载矿物质淀粉颗粒作为一种通过表层下靶向矿物质递送治疗早期龋病的新方法，具有使牙釉质再矿化的潜力。体外研究结果表明，靶向颗粒提高了治疗效果，数据支持MLCS - FP和FF配方在表层下再矿化和视觉美观方面优于对照条件。
