New approaches to enhanced remineralization of tooth enamel

J Dent Res. 2010 Nov;89(11):1187-97. doi: 10.1177/0022034510376046. Epub 2010 Aug 25.


Dental caries is a highly prevalent diet-related disease and is a major public health problem. A goal of modern dentistry is to manage non-cavitated caries lesions non-invasively through remineralization in an attempt to prevent disease progression and improve aesthetics, strength, and function. Remineralization is defined as the process whereby calcium and phosphate ions are supplied from a source external to the tooth to promote ion deposition into crystal voids in demineralized enamel, to produce net mineral gain. Recently, a range of novel calcium-phosphate-based remineralization delivery systems has been developed for clinical application. These delivery systems include crystalline, unstabilized amorphous, or stabilized amorphous formulations of calcium phosphate. These systems are reviewed, and the technology with the most scientific evidence to support its clinical use is the remineralizing system utilizing casein phosphopeptides to stabilize and deliver bioavailable calcium, phosphate, and fluoride ions. The recent clinical evidence for this technology is presented and the mechanism of action discussed. Biomimetic approaches to stabilization of bioavailable calcium, phosphate, and fluoride ions and the localization of these ions to non-cavitated caries lesions for controlled remineralization show promise for the non-invasive management of dental caries.

Publication types

  • Review

MeSH terms

  • Biological Availability
  • Biomimetic Materials / therapeutic use
  • Calcium Phosphates / pharmacokinetics
  • Calcium Phosphates / therapeutic use
  • Cariostatic Agents / pharmacokinetics
  • Cariostatic Agents / therapeutic use
  • Caseins / pharmacokinetics
  • Caseins / therapeutic use
  • Dental Caries / metabolism
  • Dental Caries / prevention & control
  • Dental Enamel / drug effects
  • Dental Enamel / pathology
  • Disease Progression
  • Fluorides / pharmacokinetics
  • Fluorides / therapeutic use
  • Humans
  • Tooth Remineralization / methods*


  • Calcium Phosphates
  • Cariostatic Agents
  • Caseins
  • casein phosphopeptide-amorphous calcium phosphate nanocomplex
  • Fluorides