CC BY-NC-ND 4.0 · ZWR - Das Deutsche Zahnärzteblatt 2020; 129(06): 277-283
DOI: 10.1055/a-1167-4888
Fortbildung
Kariologie

Hydroxylapatit als biomimetischer Wirkstoff für die Remineralisation von Zahnschmelz und Dentin

Joachim Enax
,
Helge-Otto Fabritius
,
Bennett T. Amaechi
,
Frederic Meyer

In der Mundhöhle herrscht ein dynamisches Gleichgewicht zwischen Demineralisation und Remineralisation des Zahnminerals. Dieses Gleichgewicht kann durch bakterielle Biofilme (Karies) oder säurehaltige Nahrungsmittel (Erosion) in Richtung der unerwünschten Demineralisation verschoben werden. Eine Möglichkeit, den Zahnschmelz und das Dentin mit einem Wirkstoff zu remineralisieren, ist die Verwendung von partikulärem Hydroxylapatit [Ca5(PO4)3(OH)].



Publication History

Article published online:
23 June 2020

© .

Georg Thieme Verlag KG
Stuttgart · New York

 
  • Literatur

  • 1 Teaford MF, Smith MM, Ferguson MWJ. Development, function and evolution of teeth. Cambridge: Cambridge University Press; 2000
  • 2 Lowenstam HA, Weiner S. On Biomineralization. New York, London: Oxford University Press; 1989
  • 3 Dorozhkin SV, Epple M. Biological and medical significance of calcium phosphates. Angew Chem Int Ed 2002; 41: 3130-3146
  • 4 Beniash E, Stifler CA, Sun CY. et al. The hidden structure of human enamel. Nat Commun 2019; 10: 4383
  • 5 Fejerskov O, Kidd E. Dental caries: The disease and its clinical management. Oxford: Wiley; 2009
  • 6 Dawes C. What is the critical pH and why does a tooth dissolve in acid?. J Can Dent Assoc 2003; 69: 722-724
  • 7 Epple M, Enax J. Moderne Zahnpflege aus chemischer Sicht. Chem Unserer Zeit 2018; 52: 218-228
  • 8 Meyer F, Amaechi BT, Fabritius HO. et al. Overview of calcium phosphates used in biomimetic Oral care. Open Dent J 2018; 12: 406-423
  • 9 Enax J, Epple M. Synthetic hydroxyapatite as a biomimetic oral care agent. Oral Health Prev Dent 2018; 16: 7-19
  • 10 Fabritius-Vilpoux K, Enax J, Herbig M. et al. Quantitative affinity parameters of synthetic hydroxyapatite and enamel surfaces in vitro. Bioinspir Biomim Nan 2019; 8: 141-153
  • 11 Fabritius HO, Meyer F, Enax J. Biomimetik – Die Natur als Vorbild. Spektrum Wiss 2018; 12: 46-53
  • 12 Hannig M, Hannig C. Nanomaterials in preventive dentistry. Nat Nanotechnol 2010; 5: 565-569
  • 13 Enax J, Fabritius HO, Fabritius-Vilpoux K. et al. Physicochemical properties of hydroxyapatite-microclusters used in oral care (poster). IADR/PER General Session, London, England, 2018. Im Internet (Stand: 13.05.2020): https://iadr2018.zerista.com/event/member/492940
  • 14 Peetsch A, Epple M. Characterization of the solid components of three desensitizing toothpastes and a mouth wash. Materialwiss Werkstofftech 2011; 42: 131-135
  • 15 Schlagenhauf U, Kunzelmann KH, Hannig C. et al. Impact of a non-fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries-susceptible orthodontic patients: A randomized, controlled 6-month trial. J Invest Clin Dent 2019; 10: e12399
  • 16 Hagenfeld D, Prior K, Harks I. et al. No differences in microbiome changes between anti-adhesive and antibacterial ingredients in toothpastes during periodontal therapy. J Periodont Res 2019; 54: 435-443
  • 17 Harks I, Jockel-Schneider Y, Schlagenhauf U. et al. Impact of the daily use of a microcrystal hydroxyapatite dentifrice on de novo plaque formation and clinical/microbiological parameters of periodontal health. A randomized trial. PLoS One 2016; 11: e0160142
  • 18 Hiller KA, Buchalla W, Grillmeier I. et al. In vitro effects of hydroxyapatite containing toothpastes on dentin permeability after multiple applications and ageing. Sci Rep 2018; 8: 4888
  • 19 Kensche A, Holder C, Basche S. et al. Efficacy of a mouthrinse based on hydroxyapatite to reduce initial bacterial colonisation in situ. Arch Oral Biol 2017; 80: 18-26
  • 20 Hannig C, Basche S, Burghardt T. et al. Influence of a mouthwash containing hydroxyapatite microclusters on bacterial adherence in situ. Clin Oral Investig 2013; 17: 805-814
  • 21 Tschoppe P, Zandim DL, Martus P. et al. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J Dent 2011; 39: 430-437
  • 22 Jin J, Xu X, Lai G. et al. Efficacy of tooth whitening with different calcium phosphate-based formulations. Eur J Oral Sci 2013; 121: 382-388
  • 23 Hüttemann RW, Dönges H. Untersuchungen zur Therapie überempfindlicher Zahnhälse mit Hydroxylapatit. Dtsch Zahnärztl Z 1987; 42: 486-488
  • 24 Amaechi BT, AbdulAzees PA, Alshareif DO. et al. Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ Open 2019; 5: 18
  • 25 Najibfard K, Ramalingam K, Chedjieu I. et al. Remineralization of early caries by a nano-hydroxyapatite dentifrice. J Clin Dent 2011; 22: 139-143
  • 26 Vano M, Derchi G, Barone A. et al. Reducing dentine hypersensitivity with nano-hydroxyapatite toothpaste: a double-blind randomized controlled trial. Clin Oral Investig 2018; 22: 313-320
  • 27 Orsini G, Procaccini M, Manzoli L. et al. A 3-day randomized clinical trial to investigate the desensitizing properties of three dentifrices. J Periodontol 2013; 84: 65-73
  • 28 Orsini G, Procaccini M, Manzoli L. et al. A double-blind randomized-controlled trial comparing the desensitizing efficacy of a new dentifrice containing carbonate/hydroxyapatite nanocrystals and a sodium fluoride/potassium nitrate dentifrice. J Clin Periodontol 2010; 37: 510-517
  • 29 Sudradjat H, Meyer F, Loza K. et al. In vivo effects of a hydroxyapatite-based oral care gel on the calcium and phosphorus levels of dental plaque. Eur J Dent 2020; DOI: 10.1055/s-0040-1708456.
  • 30 van Loveren C. Toothpastes. Basel: Karger; 2013
  • 31 Kani K, Kani M, Isozaki A. et al. Effect of apatite-containing dentifrices on dental caries in school children. J Dent Health 1989; 19: 104-109
  • 32 Lv K, Zhang J, Meng X. et al. Remineralization effect of the nano-HA toothpaste on artificial caries. Key Eng Mater 2007; 330 – 332: 267-270
  • 33 Kim MY, Kwon HK, Choi CH. et al. Combined effects of nano-hydroxyapatite and NaF on remineralization of early caries lesion. Key Eng Mater 2007; 330 – 332: 1347-1350
  • 34 Huang SB, Gao SS, Yu HY. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomed Mater 2009; 4: 034104 doi:10.1088/1748-6041/4/3/034104
  • 35 Enax J, Epple M. Die Charakterisierung von Putzkörpern in Zahnpasten. Dtsch Zahnärztl Z 2018; 73: 100-108
  • 36 Brown PW, Constantz B. Hydroxyapatite and related materials. Boca Raton: CRC Press; 1994
  • 37 Epple M. Review of potential health risks associated with nanoscopic calcium phosphate. Acta Biomater 2018; 77: 1-14
  • 38 Bundesinstitut für Risikobewertung. Für gesunde Zähne: Fluorid-Vorbeugung bei Säuglingen und Kleinkindern. 2018 DOI: 10.17590/20180531-085715-0
  • 39 Verordnung (EG) Nr. 1223/2009 des Europäischen Parlaments und des Rates vom 30. November 2009 über kosmetische Mittel; 2009. Im Internet (Stand: 29.04.2020): https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2009:342:0059:0209:DE:PDF
  • 40 Meyer F, Enax J. Early childhood caries: Epidemiology, aetiology, and prevention. Int J Dent 2018; 2018: 1-7
  • 41 Enax J, Fabritius HO, Fabritius-Vilpoux K. et al. Modes of action and clinical efficacy of particulate hydroxyapatite in preventive oral health care – state of the art. Open Dent J 2019; 13: 274-287
  • 42 Hu ML, Zheng G, Zhang YD. et al. Effect of desensitizing toothpastes on dentine hypersensitivity: A systematic review and meta-analysis. J Dent 2018; 75: 12-21
  • 43 Gillam DG. Dentine hypersensitivity: Advances in diagnosis, management, and treatment. New York: Springer International Publishing; 2015
  • 44 Hegazy SA, Salama IR. Antiplaque and remineralizing effects of Biorepair mouthwash: A comparative clinical trial. Pediatr Dent J 2016; 26: 89-94
  • 45 Meyer F, Fabritius HO, Enax J. Spezielle Zahnpflege bei Dentinhypersensibilität. ZMK 2017; 33: 865-868
  • 46 Jones CG. Chlorhexidine: is it still the gold standard?. Periodontol 2000 1997; 15: 55-62
  • 47 Frese C, Wohlrab T, Sheng L. et al. Clinical effect of stannous fluoride and amine fluoride containing oral hygiene products: A 4-year randomized controlled pilot study. Sci Rep 2019; 9: 7681
  • 48 Brading MG, Marsh PD. The oral environment: the challenge for antimicrobials in oral care products. Int Dent J 2003; 53: 353-362
  • 49 Epple M, Meyer F, Enax J. A critical review of modern concepts for teeth whitening. Dent J (Basel) 2019; 7: 79
  • 50 Niwa M, Sato T, Li W. et al. Polishing and whitening properties of toothpaste containing hydroxyapatite. J Mater Sci Mater Med 2001; 12: 277-281
  • 51 Aoki H, Matsuda K, Aoki H, Daisaku T, Sato T, Niwa M. Clinical Study of Teeth whitening Properties of Toothpastes containing Hydroxyapatite. In: LeGeros RZ, LeGeros JP. eds. Bioceramics Volume 11. Proceedings of the 11th International Symposium on Ceramics in Medicine: New York City, New York, USA, 5 – 8 November 1998. Singapore, New Jersey, London, Hong Kong: World Scientific; 1998: 575-577
  • 52 Bommer C, Flessa HP, Xu X. et al. Hydroxyapatite and self-assembling peptide matrix for non-oxidizing tooth whitening. J Clin Dent 2018; 29: 57-63
  • 53 Dabanoglu A, Wood C, Garcia-Godoy F. et al. Whitening effect and morphological evaluation of hydroxyapatite materials. Am J Dent 2009; 22: 23-29
  • 54 Meyer F, Enax J. Die Mundhöhle als Ökosystem. Biol Unserer Zeit 2018; 1: 62-68
  • 55 Deinzer R, Schmidt R, Harnacke D. et al. Finding an upper limit of what might be achievable by patients: oral cleanliness in dental professionals after self-performed manual oral hygiene. Clin Oral Investig 2018; 22: 839-846
  • 56 Jordan AR, Micheelis W. Fünfte Deutsche Mundgesundheitsstudie (DMS V). Köln: Institut der Deutschen Zahnärzte; 2016. Im Internet (Stand: 29.04.2020): https://www.idz.institute/publikationen/buecher/fuenfte-deutsche-mundgesundheitsstudie-dms-v.html
  • 57 Deutsche Arbeitsgemeinschaft für Jugendzahnpflege. Epidemiologische Begleituntersuchungen zur Gruppenprophylaxe 2016. Im Internet (Stand: 29.04.2020): https://www.daj.de/Studien.29.0.html
  • 58 Walsh T, Worthington HV, Glenny AM. et al. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev 2019; (03) CD007868
  • 59 OʼReilly MM, Featherstone JD. Demineralization and remineralization around orthodontic appliances: an in vivo study. Am J Orthod Dentofacial Orthop 1987; 92: 33-40
  • 60 Ismail AI, Sohn W, Tellez M. et al. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 2007; 35: 170-178
  • 61 Amaechi BT, AbdulAzees PA, Enax J. et al. Hydroxyapatite vs. fluoride gel for remineralization of caries lesion: an in vitro comparison. ORCA congress, Cagliari, Italy 2020. Abstract accepted.
  • 62 Meyer F, Enax J. Demografische Entwicklung und häusliche Zahnpflege. ZWR – Das Deutsche Zahnärzteblatt 2018; 127: 98-104
  • 63 de Carvalho FG, Vieira BR, Santos RL. et al. In vitro effects of nano-hydroxyapatite paste on initial enamel carious lesions. Pediatr Dent 2014; 36: 85-89
  • 64 Esteves-Oliveira M, Meyer-Lueckel H, Wierichs RJ. et al. Caries-preventive effect of anti-erosive and nano-hydroxyapatite-containing toothpastes in vitro. Clin Oral Investig 2017; 21: 291-300
  • 65 Scholz KJ, Federlin M, Hiller KA. et al. EDX-analysis of fluoride precipitation on human enamel. Sci Rep 2019; 9: 13442
  • 66 Hornby K, Evans M, Long M. et al. Enamel benefits of a new hydroxyapatite containing fluoride toothpaste. Int Dent J 2009; 59: 325-331
  • 67 Lelli M, Marchetti M, Foltran I. et al. Remineralization and repair of enamel surface by biomimetic Zn-carbonate hydroxyapatite containing toothpaste: a comparative in vivo study. Front Physiol 2014; 5: 333
  • 68 Fabritius-Vilpoux K, Enax J, Meyer F. et al. In vitro microstructural analysis of erosion protection by a hydroxyapatite-gel (poster). IADR/AADR/CADR General Session, Washington, USA, 2020. Im Internet (Stand: 29.04.2020): https://iadr.abstractarchives.com/abstract/20iags-3287360/in-vitro-microstructural-analysis-of-erosion-protection-by-a-hydroxyapatite-gel
  • 69 Cieplik F, Rupp CM, Hirsch S. et al. Ca2+ release and buffering effects of synthetic hydroxyapatite following bacterial acid challenge. BMC Oral Health 2020; 20: 85
  • 70 Astasov-Frauenhoffer M, Varenganayil MM, Decho AW. et al. Exopolysaccharides regulate calcium flow in cariogenic biofilms. PLoS One 2017; 12: e0186256
  • 71 Shaw L, Murray JJ, Burchell CK. et al. Calcium and phosphorus content of plaque and saliva in relation to dental caries. Caries Res 1983; 17: 543-548