Clinical and Technological Evaluation of the Remineralising Effect of Biomimetic Hydroxyapatite in a Population Aged 6 to 18 Years: A Randomized Clinical Trial.

Abstract

The aim of this randomized clinical trial was to evaluate the efficacy of two different remineralising toothpastes in preventing dental caries and promoting oral health. Patients aged 6-18 years old with healthy and fully erupted first permanent molars (C1 and C2 DIAGNOdent scores) were enrolled and randomized into two groups according to the home-hydroxyapatite-based remineralising treatment used: the Trial group used zinc carbonate hydroxyapatite-based treatment (Biorepair Total Protective Repair), while the Control group used magnesium strontium carbonate hydroxyapatite conjugated with chitosan toothpaste (Curasept Biosmalto Caries Abrasion & Erosion). Dental and periodontal parameters were measured over a six-month period, including the DIAGNOdent Pen Index (primary outcome), BEWE Index, Plaque Index, Bleeding Score, Schiff Air Index, and ICDAS assessed with DIAGNOcam. A total of 40 patients were equally allocated in the two groups and finally analyzed. A significant reduction in the DIAGNOdent Pen score was reported in the Trial group after 1 month of treatment, while in the Control group, no significant change was found. The Trial group also showed a significant reduction in plaque levels after 3 months of treatment, while in the Control group, it occurred after 1 month. However, the Bleeding Score and Schiff Air Index showed no significant differences between the groups, suggesting that additional measures may be required to address gingival inflammation and hypersensitivity. The ICDAS index also showed no statistically significant changes, due to the limited duration of this study. Overall, zinc-hydroxyapatite-based toothpaste was more effective than magnesium strontium carbonate hydroxyapatite toothpaste in enhancing enamel remineralisation in the short-term period. The assigned treatments did not result in significant improvements in the oral indexes assessed in this study.