New frontiers in the early management of enamel caries lesions and defects
Bianca Golzio Navarro Cavalcante
Dental Research Division
Dr. Varga Gábor
BC22 Irodaház Marcus Aurelius terem
2025-04-23 08:30:00
Dental Research
Dr. Varga Gábor
Dr. Varga Gábor
Dr. Victor-Vlad Costan
Dr. Stjepan Spalj
Dr. Baráth Zoltán
Dr. Reinhilde Jacobs
Dr. Oleh Andrukhov
Dental caries and molar-incisor hypomineralization (MIH) are significant global health challenges, impacting over 30% and 13% of the global population worldwide. Despite recent advances, the efficacy of early management using non-invasive strategies remains unclear. Caries can progress to cavitation if untreated, requiring invasive treatment and increasing the risk of tooth loss. Similarly, MIH-affected enamel is porous, less mineralized, and prone to breakdown, complicating treatment and prognosis. Hypersensitivity, affecting nearly half of MIH patients, adds further challenges. This research investigates the efficacy of remineralizing agents, such as fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), in managing these conditions.
Study I evaluated the combined efficacy of CPP-ACP and fluoride compared to fluoride alone in managing white spot lesions (WSLs). Study II examined CPP-ACP and other agents for remineralizing MIH lesions and reducing hypersensitivity. Both studies used fluorescence-based and visual assessment methods to analyze outcomes. Study I found that CPP-ACP combined with fluoride did not significantly outperform fluoride alone in improving WSLs. Fluoride alone was effective in arresting or reversing early carious lesions. However, the certainty of evidence was very low, underscoring the need for high-quality studies to develop treatments that better complement fluoride in managing WSLs. In Study II, CPP-ACP was not significantly superior to fluoride in remineralizing MIH lesions but was more effective in reducing hypersensitivity. Other agents, such as silver diamine fluoride (SDF), calcium glycerophosphate (CaGP), and low-level laser therapy, showed mild-to-moderate effects on remineralization and hypersensitivity but lacked robust evidence due to heterogeneity and short follow-ups.
The findings from this research address critical knowledge gaps, providing insights into the limitations and potential of non-invasive strategies for managing caries and MIH. It impacts clinical decision-making and emphasizes the importance of tailored evidence-based approaches to improve patient outcomes, reduce the burden of invasive treatments, and guide future research toward establishing standardized clinical protocols.
