Comparative study of dentin remineralization with Nano-amorphous calcium phosphate-modified bioactive restoratives

Modern caries management emphasizes minimally invasive techniques to promote remineralization through a balanced pH and mineral ion availability. Bioactive restorative materials, including giomer (Beautiful II, SHOFU Dental GmbH, Japan), and ACTIVA BioACTIVE (Pulpdent Corp., Watertown, MA, USA), release fluoride, calcium, and phosphate to enhance dentin remineralization. Nano-amorphous calcium phosphate (NACP) is a highly reactive mineral with proven remineralization capabilities due to its high surface area and solubility. The synergistic effects of NACP and the bioactive materials remain underexplored. This study evaluates the remineralization potential of giomer and ACTIVA BioACTIVE with and without NACP integration using energy-dispersive X-ray spectroscopy (EDX) microanalysis and Knoop hardness number (KHN) assessments.

Four restorative composite materials: Beautifil II, Beautifil II with NACP, ACTIVA BioACTIVE, and ACTIVA BioACTIVE with NACP, were evaluated on demineralized dentin cavities created in non-carious molars. The mineral content (Ca, P, F) was analyzed via EDX, and the microhardness was measured using KHN. Statistical analyses included analysis of variance (ANOVA) and post hoc Tukey tests.

NACP significantly increased calcium and phosphate deposition, with ACTIVA BioACTIVE with NACP demonstrating the highest remineralization (Ca/P ratio: 2.16). Fluoride intensities were higher in the giomer-based materials, promoting fluorapatite formation. KHN analysis revealed that Beautifil II with NACP exhibited the highest hardness, whereas ACTIVA BioACTIVE with NACP showed reduced hardness despite enhanced mineral content.

The incorporation of NACP into giomer and ACTIVA BioACTIVE facilitated the accumulation of calcium and phosphate ions, leading to enhanced mineralization.