Guided tissue remineralisation of partially demineralised human dentine

Biomineralisation is a well-regulated process mediated by extracellular matrix proteins. Biomimetic remineralisation strategies should reproduce the dimension and structural hierarchy of apatite deposits within a demineralised collagen matrix. Interfibrillar and intrafibrillar remineralisation of phosphoric acid-etched human dentine was demonstrated in this study using a Portland cement/phosphate-containing fluid system in the presence of polyacrylic acid and polyvinylphosphonic acid as respective calcium phosphate- and collagen-binding matrix protein analogues. Metastable amorphous calcium phosphate nanoprecursors were generated when polyacrylic acid was included in the phosphate-containing fluid. When both polyvinylphosphonic acid and polyacrylic acid were included, these nanoprecursors were attracted to the acid-demineralised collagen matrix and transformed into polyelectrolyte-stabilised apatite nanocrystals that assembled along the microfibrils (intrafibrillar remineralisation) and surface of the collagen fibrils (interfibrillar remineralisation). Transition from nanocrystals to larger apatite platelets probably occurred via the formation of mesocrystal intermediates. Guided tissue remineralisation is potentially useful in the remineralisation of acid-etched dentine that is incompletely infiltrated by dentine adhesives, as well as partially demineralised caries-affected dentine.