The remineralization potential of strontium-doped nanohydroxyapatite in dental applications- A systematic review

Introduction: Restorative dentistry has recently changed its approach and now favours a conservative method that utilises remineralisation techniques as the best way to restore damaged tooth structure. Instead of relying on traditional restorative procedures, dentists are now focused on detecting and preventing tooth decay at an early stage to preserve the tooth and avoid costly and painful treatments for the patient. This new preventive approach is more efficient for the dentist and more beneficial for the patient.This systematic review aimed to investigate and map the evidence of the remineralization potential of Strontiumdoped nanohydroxyapatite (Sr-nHAP) in dental applications and explore its use as a novel toothpaste. Material and Methods: The authors conducted a literature search using PubMed, Google Scholar, and Cochrane Central Register of Controlled Trials, using MeSH terms and keywords related to strontium-doped nanohydroxyapatite and dentifrices. The search was conducted on publications between January 2012 and February 2023. Inclusion criteria were studies that researched the impact of Sr-nHAP mineralization on hard dental tissues and those that used Sr-nHAP in dental applications. Exclusion criteria were studies that did not use Sr-nHAP or nHAP, and non-English publications. Results: Out of the 2685 publications initially identified, 7 studies were included in the review. The results showed that the use of Sr-nHAP in dental applications improved remineralization potential and antibacterial activity. Furthermore, the substitution of strontium enhanced the antibacterial properties and the ability to promote remineralization, making Sr-nHAP a promising material for toothpaste. Result: The systematic review found that the use of Sr-nHAP in dental applications could be a promising technique to prevent disease progression, improve aesthetics, strength, and function of non-cavitated caries lesions. Sr-nHAP showed better remineralization potential than traditional fluoride and was effective in reducing tooth sensitivity and blocking dentin tubules. Sr-nHAP was also found to have improved antimicrobial activity against major causes of periodontal disease. Discussion: Sr-nHAP could be a promising material for toothpaste due to its remineralization potential, antibacterial activity, and deep curing depth, which would help prevent dental caries and periodontal disease. Sr-nHAP has the potential to provide a conservative approach to restorative dentistry, avoiding costly and painful treatments for the patient, and providing an efficient approach for the dentist.