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01-09-2021 | Streptococci | Original Article

Remineralization effectiveness of adhesive containing amorphous calcium phosphate nanoparticles on artificial initial enamel caries in a biofilm-challenged environment

Authors: Menglin Fan, Jiaojiao Yang, Hockin H. K. Xu, Michael D. Weir, Siying Tao, Zhaohan Yu, Yifang Liu, Meng Li, Xuedong Zhou, Kunneng Liang, Jiyao Li

Published in: Clinical Oral Investigations | Issue 9/2021

Abstract

Objectives

Dental caries is closely associated with acid-producing bacteria, and Streptococcus mutans is one of the primary etiological agents. Bacterial accumulation and dental demineralization lead to destruction of bonding interface, thus limiting the longevity of composite. The present study investigated remineralization effectiveness of adhesive containing nanoparticles of amorphous calcium phosphate (NACP) in a stimulated oral biofilm environment.

Methods

The enamel blocks were immersed in demineralization solution for 72 h to imitate artificial initial carious lesion and then subjected to a Streptococcus mutans biofilm for 24 h. All the samples then underwent 4-h demineralization in brain heart infusion broth with sucrose (BHIS) and 20-h remineralization in artificial saliva (AS) for 7 days. The daily pH of BHIS after 4-h incubation, lactic acid production, colony-forming unit (CFU) count, and content of calcium (Ca) and phosphate (P) in biofilm were evaluated. Meanwhile, the remineralization effectiveness of enamel was analyzed by X-ray diffraction (XRD), surface microhardness testing, transverse microradiography (TMR) and scanning electron microscopy (SEM).

Results

The NACP adhesive released abundant Ca and P, achieved acid neutralization, reduced lactic acid production, and lowered CFU count (P < 0.05). Enamel treated with NACP adhesive demonstrated the best remineralization effectiveness with remineralization value of 52.29 ± 4.79% according to TMR. Better microhardness recovery of cross sections and ample mineral deposits were also observed in NACP group.

Conclusions

The NACP adhesive exhibited good performance in remineralizing initial enamel lesion with cariogenic biofilm.

Significance

The NACP adhesive is promising to be applied for the protection of bonding interface, prevention of secondary caries, and longevity prolonging of the restoration.

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de Oliveira MAMF, Celeste RK, Rodrigues CC, Marinho VC, Walsh T (2018, 2018) Topical fluoride for treating dental caries. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD003454

Fontana M, Young DA, Wolff MS, Pitts NB, Longbottom C (2010) Defining dental caries for 2010 and beyond. Dent Clin N Am 54:423–440. https://doi.org/10.1016/j.cden.2010.03.007CrossRefPubMed

Slayton RL, Urquhart O, Araujo MWB, Fontana M, Guzman-Armstrong S, Nascimento MM, Novy BB, Tinanoff N, Weyant RJ, Wolff MS, Young DA, Zero DT, Tampi MP, Pilcher L, Banfield L, Carrasco-Labra A (2018) Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: a report from the American Dental Association. J Am Dent Assoc 149:837–849. e19. https://doi.org/10.1016/j.adaj.2018.07.002CrossRefPubMed

Pashley DH, Tay FR, Breschi L, Tjaderhane L, Carvalho RM, Carrilho M, Tezvergil-Mutluay A (2011) State of the art etch-and-rinse adhesives. Dent Mater 27:1–16. https://doi.org/10.1016/j.dental.2010.10.016CrossRefPubMed

Lynch CD, Frazier KB, McConnell RJ, Blum IR, Wilson NH (2011) Minimally invasive management of dental caries: contemporary teaching of posterior resin-based composite placement in US and Canadian dental schools. J Am Dent Assoc 142:612–620. https://doi.org/10.14219/jada.archive.2011.0243CrossRefPubMed

Demarco FF, Corrêa MB, Cenci MS, Moraes RR, Opdam NJ (2012) Longevity of posterior composite restorations: not only a matter of materials. Dent Mater 28:87–101. https://doi.org/10.1016/j.dental.2011.09.003CrossRefPubMed

Montagner AF, Maske TT, Opdam NJ, De Soet JJ, Cenci MS, Huysmans M-C (2016) Failed bonded interfaces submitted to microcosm biofilm caries development. J Dent 52:63–69. https://doi.org/10.1016/j.jdent.2016.07.007CrossRefPubMed

Brambilla E, Cagetti MG, Gagliani M, Fadini L, Garcia-Godoy F, Strohmenger L (2005) Influence of different adhesive restorative materials on mutans streptococci colonization. Am J Dent 18:173–176PubMed

Bakrya AS, Sadr A, Inoue G, Otsuki M, Tagami J (2007) Effect of Er: YAG laser treatment on the microstructure of the dentin/adhesive interface after acid-base challenge. J Adhes Dent 9:513–520

10.

Johansson I, Witkowska E, Kaveh B, Lif Holgerson P, Tanner AC (2016) The microbiome in populations with a low and high prevalence of caries. J Dent Res 95:80–86. https://doi.org/10.1177/0022034515609554CrossRefPubMedPubMedCentral

11.

Rogers S, Chadwick B, Treasure E (2010) Fluoride-containing orthodontic adhesives and decalcification in patients with fixed appliances: a systematic review. Am J Orthod Dentofac Orthop 138:390 e1–390 e8. https://doi.org/10.1016/j.ajodo.2010.02.025CrossRef

12.

Chin MY, Sandham A, Rumachik EN, Ruben JL, Huysmans M-CD (2009) Fluoride release and cariostatic potential of orthodontic adhesives with and without daily fluoride rinsing. Am J Orthod Dentofac Orthop 136:547–553. https://doi.org/10.1016/j.ajodo.2007.10.053CrossRef

13.

Akabane S, Delbem AC, Pessan J, Garcia L, Emerenciano N, Goncalves DF, Danelon M (2018) In situ effect of the combination of fluoridated toothpaste and fluoridated gel containing sodium trimetaphosphate on enamel demineralization. J Dent 68:59–65. https://doi.org/10.1016/j.jdent.2017.10.013CrossRefPubMed

14.

Wong MC, Glenny AM, Tsang BW, Lo EC, Worthington HV, Marinho (2010) Topical fluoride as a cause of dental fluorosis in children. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD007693.pub2

15.

Zhang L, Weir MD, Chow LC, Reynolds MA, Xu HH (2016) Rechargeable calcium phosphate orthodontic cement with sustained ion release and re-release. Sci Rep 6:36476. https://doi.org/10.1038/srep36476CrossRefPubMedPubMedCentral

16.

Shen Y-Q, Zhu Y-J, Chen F-F, Jiang Y-Y, Xiong Z-C, Chen F (2018) Antibacterial gluey silver–calcium phosphate composites for dentine remineralization. J Mater Chem B 6:4985–4994. https://doi.org/10.1039/c8tb00881gCrossRefPubMed

17.

Tay FR, Pashley DH (2009) Biomimetic remineralization of resin-bonded acid-etched dentin. J Dent Res 88:719–724. https://doi.org/10.1177/0022034509341826CrossRefPubMedPubMedCentral

18.

Melo MA, Cheng L, Zhang K, Weir MD, Rodrigues LK, Xu HH (2013) Novel dental adhesives containing nanoparticles of silver and amorphous calcium phosphate. Dent Mater 29:199–210. https://doi.org/10.1016/j.dental.2012.10.005CrossRefPubMed

19.

Melo MAS, Cheng L, Weir MD, Hsia RC, Rodrigues LK, Xu HH (2013) Novel dental adhesive containing antibacterial agents and calcium phosphate nanoparticles. J Biomed Mater Res B Appl Biomater 101:620–629. https://doi.org/10.1002/jbm.b.32864CrossRefPubMed

20.

Chen H, Gu L, Liao B, Zhou X, Cheng L, Ren BJM (2020) Advances of anti-caries nanomaterials. Molecules 25:5047. https://doi.org/10.3390/molecules25215047CrossRefPubMedCentral

21.

Moreau JL, Sun L, Chow LC, Xu HH (2011) Mechanical and acid neutralizing properties and bacteria inhibition of amorphous calcium phosphate dental nanocomposite. J Biomed Mater Res B Appl Biomater 98:80–88. https://doi.org/10.1002/jbm.b.31834CrossRefPubMedPubMedCentral

22.

Weir MD, Chow LC, Xu HH (2012) Remineralization of demineralized enamel via calcium phosphate nanocomposite. J Dent Res 91:979–984. https://doi.org/10.1177/0022034512458288CrossRefPubMedPubMedCentral

23.

Liang K, Gao Y, Xiao S, Tay FR, Weir MD, Zhou X, Oates TW, Zhou C, Li J, Xu HHK (2019) Poly(amido amine) and rechargeable adhesive containing calcium phosphate nanoparticles for long-term dentin remineralization. J Dent 85:47–56. https://doi.org/10.1016/j.jdent.2019.04.011CrossRefPubMed

24.

Zhang M, He LB, Exterkate RA, Cheng L, Li JY, Ten Cate JM, Crielaard W, Deng DM (2015) Biofilm layers affect the treatment outcomes of NaF and Nano-hydroxyapatite. J Dent Res 94:602–607. https://doi.org/10.1177/0022034514565644CrossRefPubMed

25.

Watson P, Pontefract H, Devine D, Shore R, Nattress B, Kirkham J, Robinson C (2005) Penetration of fluoride into natural plaque biofilms. J Dent Res 84:451–455. https://doi.org/10.1177/154405910508400510CrossRefPubMed

26.

Xu HH, Moreau JL, Sun L, Chow LC (2011) Nanocomposite containing amorphous calcium phosphate nanoparticles for caries inhibition. Dent Mater 27:762–769. https://doi.org/10.1016/j.dental.2011.03.016CrossRefPubMedPubMedCentral

27.

Zhang N, Chen C, Weir MD, Bai Y, Xu HH (2015) Antibacterial and protein-repellent orthodontic cement to combat biofilms and white spot lesions. J Dent 43:1529–1538. https://doi.org/10.1016/j.jdent.2015.09.006CrossRefPubMedPubMedCentral

28.

Melo MA, Wu J, Weir MD, Xu HH (2014) Novel antibacterial orthodontic cement containing quaternary ammonium monomer dimethylaminododecyl methacrylate. J Dent 42:1193–1201. https://doi.org/10.1016/j.jdent.2014.07.006CrossRefPubMedPubMedCentral

29.

Akhavan A, Sodagar A, Mojtahedzadeh F, Sodagar K (2013) Investigating the effect of incorporating nanosilver/nanohydroxyapatite particles on the shear bond strength of orthodontic adhesives. Acta Odontol Scand 71:1038–1042. https://doi.org/10.3109/00016357.2012.741699CrossRefPubMed

30.

Tao S, Fan M, Xu HH, Li J, He L, Zhou X, Liang K, Li J (2017) The remineralization effectiveness of PAMAM dendrimer with different terminal groups on demineralized dentin in vitro. RSC Adv 7:54947–54955. https://doi.org/10.1039/C7RA11844ACrossRef

31.

Fan M, Zhang M, Xu HHK, Tao S, Yu Z, Yang J, Yuan H, Zhou X, Liang K, Li J (2020) Remineralization effectiveness of the PAMAM dendrimer with different terminal groups on artificial initial enamel caries in vitro. Dent Mater 36:210–220. https://doi.org/10.1016/j.dental.2019.11.015

32.

Silva AP, Goncalves RS, Borges AF, Bedran-Russo AK, Shinohara MS (2015) Effectiveness of plant-derived proanthocyanidins on demineralization on enamel and dentin under artificial cariogenic challenge. J Appl Oral Sci 23:302–309. https://doi.org/10.1590/1678-775720140304CrossRefPubMedPubMedCentral

33.

Taha AA, Fleming PS, Hill RG, Patel MP (2018) Enamel remineralization with novel bioactive glass air abrasion. J Dent Res 97:1438–1444. https://doi.org/10.1177/0022034518792048CrossRefPubMed

34.

Lv X, Yang Y, Han S, Li D, Tu H, Li W, Zhou X, Zhang L (2015) Potential of an amelogenin based peptide in promoting reminerlization of initial enamel caries. Arch Oral Biol 60:1482–1487. https://doi.org/10.1016/j.archoralbio.2015.07.010CrossRefPubMed

35.

Yang Y, Lv XP, Shi W, Li JY, Li DX, Zhou XD, Zhang LL (2014) 8DSS-promoted remineralization of initial enamel caries in vitro. J Dent Res 93:520–524. https://doi.org/10.1177/0022034514522815CrossRefPubMed

36.

Xue J, Li W, Swain MV (2009) In vitro demineralization of human enamel natural and abraded surfaces: a micromechanical and SEM investigation. J Dent 37:264–272. https://doi.org/10.1016/j.jdent.2008.11.020CrossRefPubMed

37.

Tao S, He L, Xu HHK, Weir MD, Fan M, Yu Z, Zhang M, Zhou X, Liang K, Li J (2019) Dentin remineralization via adhesive containing amorphous calcium phosphate nanoparticles in a biofilm-challenged environment. J Dent 89:103193. https://doi.org/10.1016/j.jdent.2019.103193CrossRefPubMed

38.

Han Q, Li B, Zhou X, Ge Y, Wang S, Li M, Ren B, Wang H, Zhang K, Xu HHK, Peng X, Feng M, Weir MD, Chen Y, Cheng L (2017) Anti-caries effects of dental adhesives containing quaternary ammonium methacrylates with different chain lengths. Materials (Basel) 10:643. https://doi.org/10.3390/ma10060643CrossRef

39.

Li F, Weir MD, Chen J, Xu HH (2013) Comparison of quaternary ammonium-containing with nano-silver-containing adhesive in antibacterial properties and cytotoxicity. Dent Mater 29:450–461. https://doi.org/10.1016/j.dental.2013.01.012CrossRefPubMedPubMedCentral

40.

Liang K, Weir MD, Reynolds MA, Zhou X, Li J, Xu HHK (2017) Poly (amido amine) and nano-calcium phosphate bonding agent to remineralize tooth dentin in cyclic artificial saliva/lactic acid. Mater Sci Eng C Mater Biol Appl 72:7–17. https://doi.org/10.1016/j.msec.2016.11.020CrossRefPubMed

41.

Liang K, Zhou H, Weir MD, Bao C, Reynolds MA, Zhou X, Li J, Xu HH (2017) Poly (amido amine) and calcium phosphate nanocomposite remineralization of dentin in acidic solution without calcium phosphate ions. Dent Mater 33:818–829. https://doi.org/10.1016/j.dental.2017.04.016CrossRefPubMed

42.

Chen C, Weir MD, Cheng L, Lin NJ, Lin-Gibson S, Chow LC, Zhou X, Xu HH (2014) Antibacterial activity and ion release of bonding agent containing amorphous calcium phosphate nanoparticles. Dent Mater 30:891–901. https://doi.org/10.1016/j.dental.2014.05.025CrossRefPubMedPubMedCentral

43.

Peris AR, Mitsui FH, Lobo MM, Bedran-russo AK, Marchi GM (2007) Adhesive systems and secondary caries formation: assessment of dentin bond strength, caries lesions depth and fluoride release. Dent Mater 23:308–316. https://doi.org/10.1016/j.dental.2006.02.001CrossRefPubMed

44.

Dickens SH, Flaim GM, Takagi S (2003) Mechanical properties and biochemical activity of remineralizing resin-based Ca–PO4 cements. Dent Mater 19:558–566. https://doi.org/10.1016/s0109-5641(02)00105-7CrossRefPubMed

45.

van Loveren C, Buijs JF, ten Cate JM (2000) The effect of triclosan toothpaste on enamel demineralization in a bacterial demineralization model. J Antimicrob Chemother 45:153–158. https://doi.org/10.1093/jac/45.2.153CrossRefPubMed

46.

Liu Y, Ding C, He L, Yang X, Gou Y, Xu X, Liu Y, Zhao C, Li J, Li J (2018) Bioinspired heptapeptides as functionalized mineralization inducers with enhanced hydroxyapatite affinity. J Mater Chem B 6:1984–1994. https://doi.org/10.1039/c7tb03067cCrossRefPubMed

47.

Yassen GH, Lippert F, Eckert G, Eder J, Zandona AF (2012) The effect of strontium and combinations of strontium and fluoride on the remineralization of artificial caries lesions in vitro. Quintessence Int 43:e95–e103. https://doi.org/10.1159/000057864CrossRefPubMed

48.

Langhorst SE, O’Donnell JN, Skrtic D (2009) In vitro remineralization of enamel by polymeric amorphous calcium phosphate composite: quantitative microradiographic study. Dent Mater 25:884–891. https://doi.org/10.1016/j.dental.2009.01.094CrossRefPubMedPubMedCentral

49.

Liang K, Xiao S, Weir MD, Bao C, Liu H, Cheng L, Zhou X, Li J, Xu HHK (2018) Poly (amido amine) dendrimer and dental adhesive with calcium phosphate nanoparticles remineralized dentin in lactic acid. J Biomed Mater Res B Appl Biomater 106:2414–2424. https://doi.org/10.1002/jbm.b.34050CrossRefPubMed

50.

Bradshaw D, Marsh P, Hodgson R, Visser J (2002) Effects of glucose and fluoride on competition and metabolism within in vitro dental bacterial communities and biofilms. Caries Res 36:81–86. https://doi.org/10.1159/000057864CrossRefPubMed

51.

Zhao J, Dong X, Bian M, Zhao J, Zhang Y, Sun Y, Chen J, Wang X (2014) Solution combustion method for synthesis of nanostructured hydroxyapatite, fluorapatite and chlorapatite. Appl Surf Sci 314:1026–1033. https://doi.org/10.1016/j.apsusc.2014.06.075CrossRef

52.

Hahnel S, Ionescu AC, Cazzaniga G, Ottobelli M, Brambilla E (2017) Biofilm formation and release of fluoride from dental restorative materials in relation to their surface properties. J Dent 60:14–24. https://doi.org/10.1016/j.jdent.2017.02.005CrossRefPubMed

53.

Thurnheer T, Belibasakis GN (2018) Effect of sodium fluoride on oral biofilm microbiota and enamel demineralization. Arch Oral Biol 89:77–83. https://doi.org/10.1016/j.archoralbio.2018.02.010CrossRefPubMed

54.

Lockner F, Twetman S, Stecksén-Blicks C (2017) Urinary fluoride excretion after application of fluoride varnish and use of fluoride toothpaste in young children. Int J Paediatr Dent 27:463–468. https://doi.org/10.1111/ipd.12284CrossRefPubMed

55.

Kirihara M, Inoue G, Nikaido T, Ikeda M, Sadr A, Tagami J (2013) Effect of fluoride concentration in adhesives on morphology of acid-base resistant zones. Dent Mater J 32:578–584. https://doi.org/10.4012/dmj.2013-041CrossRefPubMed

56.

Weir MD, Ruan J, Zhang N, Chow LC, Zhang K, Chang X, Bai Y, Xu HHK (2017) Effect of calcium phosphate nanocomposite on in vitro remineralization of human dentin lesions. Dent Mater 33:1033–1044. https://doi.org/10.1016/j.dental.2017.06.015CrossRefPubMed

57.

Wang X, Wang Y, Wang K, Ren Q, Li H, Zheng S, Niu Y, Zhou X, Li W, Zhang L (2019) Bifunctional anticaries peptides with antibacterial and remineralizing effects. Oral Dis 25:488–496. https://doi.org/10.1111/odi.12990CrossRefPubMed

58.

Kim D, Lee M-J, Kim J-Y, Lee D, Kwon J-S, Choi S-H (2019) Incorporation of zwitterionic materials into light-curable fluoride varnish for biofilm inhibition and caries prevention. Sci Rep 9:1–10. https://doi.org/10.1038/s41598-019-56131-5CrossRef

59.

Kerr JE, Arndt GD, Byerly DL, Rubinovitz R, Theriot CA, Stangel I (2016) FT-Raman spectroscopy study of the remineralization of microwave-exposed artificial caries. J Dent Res 95:342–348. https://doi.org/10.1177/0022034515619370CrossRefPubMed

60.

Xie XJ, Xing D, Wang L, Zhou H, Weir MD, Bai YX, Xu HH (2017) Novel rechargeable calcium phosphate nanoparticle-containing orthodontic cement. Int J Oral Sci 9:24–32. https://doi.org/10.1038/ijos.2016.40CrossRefPubMed

61.

Hellak A, Ebeling J, Schauseil M, Stein S, Roggendorf M, Korbmacher-Steiner H (2016) Shear bond strength of three orthodontic bonding systems on enamel and restorative materials. Biomed Res Int 2016:6307107–6307110. https://doi.org/10.1155/2016/6307107CrossRefPubMedPubMedCentral

62.

Zhang N, Weir MD, Chen C, Melo MA, Bai Y, Xu HH (2016) Orthodontic cement with protein-repellent and antibacterial properties and the release of calcium and phosphate ions. J Dent 50:51–59. https://doi.org/10.1016/j.jdent.2016.05.001CrossRefPubMed

63.

Amaechi BT, Higham S, Edgar W (1998) Use of transverse microradiography to quantify mineral loss by erosion in bovine enamel. Caries Res 32:351–356. https://doi.org/10.1159/000016471CrossRefPubMed

64.

Hamba H, Nikaido T, Sadr A, Nakashima S, Tagami J (2012) Enamel lesion parameter correlations between polychromatic micro-CT and TMR. J Dent Res 91:586–591. https://doi.org/10.1177/0022034512444127CrossRefPubMed

65.

Magalhães AC, Moron B, Comar L, Wiegand A, Buchalla W, Buzalaf MAR (2009) Comparison of cross-sectional hardness and transverse microradiography of artificial carious enamel lesions induced by different demineralising solutions and gels. Caries Res 43:474–483. https://doi.org/10.1159/000264685CrossRefPubMed

66.

Liang K, Wang S, Tao S, Xiao S, Zhou H, Wang P, Cheng L, Zhou X, Weir MD, Oates TW (2019) Dental remineralization via poly (amido amine) and restorative materials containing calcium phosphate nanoparticles. Int J Oral Sci 11:1–12. https://doi.org/10.1038/s41368-019-0048-zCrossRef

67.

Tao S, Su Z, Xiang Z, Xu HH, Weir MD, Fan M, Yu Z, Zhou X, Liang K, Li JJDM (2020) Nano-calcium phosphate and dimethylaminohexadecyl methacrylate adhesive for dentin remineralization in a biofilm-challenged environment. Dent Mater 36:e316–e328. https://doi.org/10.1016/j.dental.2020.08.001CrossRefPubMed

68.

Reynolds EC, Cai F, Cochrane NJ, Shen P, Walker GD, Morgan MV, Reynolds C (2008) Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res 87:344–348. https://doi.org/10.1177/154405910808700420CrossRefPubMed

69.

Shen P, Walker GD, Yuan Y, Reynolds C, Stanton DP, Fernando JR, Reynolds EC (2018) Importance of bioavailable calcium in fluoride dentifrices for enamel remineralization. J Dent 78:59–64. https://doi.org/10.1016/j.jdent.2018.08.005CrossRefPubMed

70.

Reynolds EC (1997) Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res 76:1587–1595. https://doi.org/10.1177/00220345970760091101CrossRefPubMed

71.

Cochrane NJ, Saranathan S, Cai F, Cross KJ, Reynolds EC (2008) Enamel subsurface lesion remineralisation with casein phosphopeptide stabilised solutions of calcium, phosphate and fluoride. Caries Res 42:88–97. https://doi.org/10.1159/000113161CrossRefPubMed

72.

Souza JGS, Tenuta LMA, Cury AADB, Nóbrega DF, Budin RR, de Queiroz MX, Vogel GL, Cury JA (2016) Calcium prerinse before fluoride rinse reduces enamel demineralization: an in situ caries study. Caries Res 50:372–377. https://doi.org/10.1159/000446407CrossRefPubMed

Title: Remineralization effectiveness of adhesive containing amorphous calcium phosphate nanoparticles on artificial initial enamel caries in a biofilm-challenged environment
Authors: Menglin Fan
Jiaojiao Yang
Hockin H. K. Xu
Michael D. Weir
Siying Tao
Zhaohan Yu
Yifang Liu
Meng Li
Xuedong Zhou
Kunneng Liang
Jiyao Li
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Streptococci
Caries
Published in: Clinical Oral Investigations / Issue 9/2021
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-021-03846-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Remineralization effectiveness of adhesive containing amorphous calcium phosphate nanoparticles on artificial initial enamel caries in a biofilm-challenged environment

Abstract

Objectives

Methods

Results

Conclusions

Significance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Significance

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