Advances in Guided Enamel Regeneration: An Comparative Study of Biomimetic and Conventional Remineralizing Agents in Primary Teeth.

To evaluate the effectiveness of various remineralizing agents on artificially induced enamel lesions in primary teeth by a pH-cycled model. Four remineralizing agents were tested on exfoliated/extracted primary human teeth in a pH-cycled model: fluoride varnish (FLV); casein phosphopeptide-amorphous calcium phosphate (CPP-ACP); self-assembling peptides-P11-4 (SAP); and poly(amidoamine) (PAMAM) dendrimers. Surface microhardness (SMH) improvement was quantitatively evaluated using Vickers hardness number testing, and surface morphology changes were qualitatively assessed with scanning electron microscopy. Compared to SAP, PAMAM had a higher VHN value, and the difference was statistically significant (P<0.001). The comparison between the FLV and CPP-ACP groups showed a non-significant difference (P=0.56). FLV demonstrated a narrow interquartile range, underscoring its reliability. PAMAM and SAP resulted in a homogenous and smooth enamel surface, indicating successful mineral deposition. FLV and CPP-ACP showed more superficial mineral recovery. The findings demonstrate each remineralizing agent's distinctive benefits and limitations in a controlled setting. Poly (amidoamine) dendrimers' standout performance suggests potential enamel repair strategies, potentially revolutionizing early carious lesion management. Fluoride varnish remains a dependable choice for clinicians, while casein phosphopeptide-amorphous calcium phosphate and self-assembling peptides-P11-4 contribute to biomimetic advancements in dentistry. Guided enamel regeneration through biomimetic approaches is aligned with minimum intervention dentistry principles and could substantially improve oral health outcomes.