Assessing in vitro remineralization of primary artificial caries: A systematic review of multi-techniques characterization approaches

Abstract

Objectives

The aim of this systematic review is to help the reader in their selection of analytical techniques for a complete and accurate assessment of artificial caries remineralization.

Data, sources and study selection

Four databases were scanned independently following PRISMA guidelines and, after setting of inclusion and exclusion criteria, 255 potentially-relevant articles were scrutinized for selection. Based on our hypothesis that at least three characteristics of the newly-formed mineral, i.e. spatial extension, chemical composition and morphology, are requested for assessment, focus was made on 24 articles where at least three methods were used.

Conclusion

Twenty different analytical methods were used and 11 studies used at least one technique relevant to each of the three characteristics. However, there was a general lack of quantitative and chemical characterization of the new mineral. These results highlight the scarcity of multi-techniques studies and the low diversity of techniques currently used in this area. We suggest that the combination of qualitative micro computed tomography combined with X-Ray diffraction or vibrational spectroscopies is the most suitable to fully assess the success of artificial caries remineralization.

Clinical significance

Modern prospective caries studies require the measurement of small changes in tooth mineral content. This can probably be achieved only by combining several diagnostic tools. Artificial caries allows for a primary practical assessment of such combinations. However, it is important to the improve the awareness and/or availability of some relevant analytical tools and to better connect laboratory and clinical objectives.