Evaluation of the remineralization potential of bioactive materials using different methods

The aim of this study was to evaluate the remineralization capacities of bioactive restorative materials with different compositions on initial enamel lesions using different evaluation methods. The study was conducted under in vitro conditions using 120 caries-free human molars. The teeth were randomly assigned to the experimental groups (Fuji Triage, ACTIVA BioACTIVE Restorative, BeautiSealant, and Premier BioCoat). Measurement areas were prepared by creating 2 mm diameter windows on the enamel surfaces in five different regions (intact enamel, lesion area after demineralization, and after material application at 1-week, 1-month, and 3-months). The materials were applied according to the manufacturers' recommendations, and the samples were stored in a simulated body fluid at 37 °C and 1 atmosphere pressure in an incubator for 3-months. Changes in enamel surface hardness were analyzed using a microhardness tester, while elemental changes were assessed using SEM-EDS analysis. SEM imaging was performed, and lesion areas were assessed using a quantitative light-induced fluorescence device (QLF-D) to measure fluorescence and lesion area changes. Statistical analyses were performed (α = 0.05). After 3-months of remineralization, all materials showed a statistically significant increase in microhardness values compared to the demineralized lesion areas (p < 0.05). EDS analysis of the 3-months data showed no statistically significant difference from sound enamel for any of the materials evaluated (p > 0.05). The QLF-D analysis showed a statistically significant decrease in lesion area and fluorescence values over time for all materials (p < 0.05). All evaluated materials contributed to lesion repair based on the evaluated parameters. Using quantitative assessment methodologies, Fuji Triage was determined to provide the highest level of remineralization. Clinical relevance: This study demonstrates the clinical potential of bioactive restorative materials as effective agents for non-invasive caries treatment by enhancing enamel remineralization through continuous ion release, supporting minimally invasive treatment approaches and long-term preservation of tooth structure.