Enamel remineralization potential of bioactive glass-containing toothpastes: an in vitro study

This study evaluated the remineralization potential of experimental containing bioactive glass, hydroxyapatite, protein-calcium glycerophosphate, and their fluoride-enriched formulations on artificially demineralized enamel. Eighty extracted human molars were sectioned into enamel specimens, and artificial caries lesions were induced. Specimens were randomly divided into eight groups (n = 10): experimental formulations (bioactive glass (MB), bioactive glass + fluoride (MBF), hydroxyapatite (MH), hydroxyapatite + fluoride (MHF), protein + calcium glycerophosphate (MP)), commercial toothpastes (Sensodyne Repair & Protect with NovaMin (MS), R.O.C.S. Sensitive (MR)), and a control group. All specimens underwent a 14-day pH-cycling protocol simulating daily demineralization and remineralization. Remineralization efficacy was assessed at baseline, post-demineralization, and post-treatment using DIAGNOdent Pen, FluoreCam imaging, and Vickers microhardness testing. Data were analyzed using ANOVA. Significance level was set at p < 0.05. The highest microhardness recovery occurred in MHF (60.65 ± 21.92) and MS (57.07 ± 24.14), while the least increase was observed in the control (9.46 ± 14.28) and MP (15.5 ± 17.23) (p < 0.001). FluoreCam analysis revealed the greatest mineral gain in MHF (4.22 ± 2.24), MS (4.12 ± 1.57), and MBF (4.02 ± 2.73); however, no significance was detected between treatment groups (p = 0.419). DIAGNOdent Pen values were lowest post-treatment in MR (6.7 ± 0.9), MBF (6.9 ± 0.94), and MS (6.9 ± 1.14), while all treatment groups had significantly lower values than the control (11.1 ± 1.45) (p < 0.001). Experimental toothpastes containing bioactive glass, hydroxyapatite, and protein- calcium glycerophosphate, as well as commercial products containing NovaMin and hydroxyapatite, supported enamel remineralization. The addition of fluoride enhanced this effect. Clinical significance This study demonstrates the potential of various remineralization agents to strengthen early enamel lesions, offering clinicians alternative non-invasive options for early caries management.