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By: Atul Khajuria and Sukhmeet Kaur Bedi.
1. Dean, Department of Allied & Health Care Sciences, Rayat Bahra Professional University Hoshiarpur – Chandigarh Rd, VPO, Bohan.
2. Dental Surgeon, Department of Allied & Health Care Sciences, Rayat Bahra Professional University, Hoshiarpur – Chandigarh Rd, VPO, Bohan, Punjab.
Background
Dental caries and erosive enamel wear remain among the most common chronic conditions worldwide, affecting more than 2 billion people and contributing to pain, tooth loss, and substantial economic costs. Conventional fluoridebased strategies reduce demineralization but do not fully restore enamel microstructure.
Source and selection of data
We searched MEDLINE, Embase, Scopus, and Cochrane Library for in vitro, in situ, and clinical studies on nanohydroxyapatite (nHAp) used for enamel remineralization, caries prevention, whitespot lesions, dentin hypersensitivity, and erosion up to January 2026. Recent systematic reviews, randomized trials, and key mechanistic papers were prioritized.
Results
nHAp closely mimics the mineral phase of enamel and dentin and, at the nanoscale, provides a highsurfacearea, bioactive scaffold that can nucleate new apatite and integrate with residual crystallites. In vitro and in situ studies consistently show that nHApcontaining dentifrices increase surface microhardness, reduce lesion depth, and deposit a hydroxyapatitelike layer on demineralized enamel, often with performance comparable to lowconcentration fluoride for early lesions. Clinical trials indicate that nHAp toothpastes are effective for dentin hypersensitivity, improvement of orthodontic whitespot lesions, and noncavitated caries, with safety comparable to conventional toothpastes. Combining nHAp with fluoride appears to enhance remineralization of whitespot lesions beyond either agent alone, but the number of welldesigned trials is still limited and followup periods are generally short.
Conclusions
nHAp is a promising biomimetic active ingredient for preventive and minimally invasive dentistry, particularly for patients at risk of fluorosis or with high demand for esthetic, noninvasive management of early enamel defects. However, current evidence is heterogeneous, and multiyear randomized trials powered for caries incidence and longterm aesthetics are needed before nHAp can be recommended as a universal replacement for fluoride.
Nano-hydroxyapatite (nHAp), Enamel remineralization, Dental caries prevention, White
spot lesions, Dentin hypersensitivity.
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Citation:
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