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Design, characterization and evaluation of biomimetic polymeric dental composites with remineralization potential pp.281-318 $100.00
Authors:  (D. Skrtic and J.M. Antonucci, Paffenbarger Research Center, American Dental Association Foundation, National Institute of Standards and Technology, Gaithersburg, and others)
During the last century, much has been learned about the process of dental caries, a
localized destruction of tooth tissue by plaque microorganisms that ferment dietary
carbohydrates into organic acids which then cause dissolution of tooth mineral. Teeth are
constantly going through cycles of mineral loss (when oral pH is below the point at
which tooth mineral begins to dissolve) and repair (neutral and/or basic pH conditions
that favor the redeposition of mineral). The net loss or gain in mineral over time
ultimately determines whether tooth decay (demineralization) will advance, stabilize
and/or regress. The major goal of clinical intervention is the preservation of tooth
structure and the prevention of lesion progression to the point where restoration is
needed. Caries prevention strategies have focused on reducing bacterial growth,
neutralizing oral acids and using various remineralizing agents. Traditionally,
remineralizing caries-arresting approaches are based on calcium and phosphate ion
delivery through the use of dentifrices, chewing gums and mouthwashes, and systemic
and/or topical fluoridation. However, restoring the lost mineral by using remineralization
solutions containing calcium and phosphate ions often fails clinically because of the low
solubility of calcium phosphates, particularly in the presence of fluoride ions and their
inability to incorporate into plaque and localize at the tooth surface [1]. Incorporation of
fluoride into dental materials is viewed by many as the scientific cornerstone for caries
prevention [2-14]. It is generally recognized that fluoride regenerates damaged tooth
enamel via incorporation in tooth mineral as fluoroapatite or fluoride-enriched
hydroxyapatite, therefore decreasing the solubility of tooth enamel. Fluoride has been
less effective as dentin remineralizing vehicle [2, 11, 13, 14]. In addition to the various
fluoride treatments, remineralization of enamel has been successfully achieved by two
distinct new technologies: a) casein-phosphopeptide stabilized amorphous calcium
phosphate (ACP) in the form of mouthrinses and sugar-free chewing gums [15-17] and b)
ACP based polymeric composites [18-20]. Dental applications of ACP also include
varnishes, dentifrices and desensitizing agents [21-24]. The development of the ACP
based remineralizing composites is discussed in this Chapter with emphasis on the
structure-composition-property relationships and comprehensive physicochemical
evaluation of composites formulated for various dental applications. 

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Design, characterization and evaluation of biomimetic polymeric dental composites with remineralization potential pp.281-318