Poly (amido amine) and nano-calcium phosphate bonding agent to remineralize tooth dentin in cyclic artificial saliva/lactic acid

The objectives of this study were to develop a novel method to remineralize dentin lesions, and investigate the remineralization effects of poly (amido amine) (PAMAM) dendrimer plus a bonding agent with nanoparticles of amorphous calcium phosphate (NACP) in a cyclic artificial saliva/lactic acid environment for the first time. Dentin lesions were produced via phosphoric acid. Four groups were tested: (1) dentin control, (2) dentin with PAMAM, (3) dentin with NACP bonding agent, and (4) dentin with PAMAM plus NACP bonding agent. Specimens were treated with cyclic artificial saliva/lactic acid. The remineralized dentin was examined using scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), hardness and attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR). NACP bonding agent yielded a dentin shear bond strength similar to commercial controls (Prime & Bond NT, Dentsply; Scotchbond Multi-purpose, 3M) (p > 0.1). Increasing NACP in bonding agent from 0 to 40% did not affect bond strength. NACP bonding agent neutralized the acid and released Ca ions with concentrations of 4 to 20 mmol/L, and P ions of 2 to 9 mmol/L. PAMAM or NACP bonding agent alone achieved slight remineralization. The PAMAM + NACP group achieved the greatest dentin remineralization p < 0.05). At 20 days, PAMAM + NACP increased the hardness of pre-demineralized dentin to reach the normal dentin hardness (p > 0.1). In conclusion, superior remineralization of PAMAM + NACP bonding agent was demonstrated for the first time. PAMAM + NACP bonding agent induced dentin remineralization under acid challenge, when conventional remineralization methods such as PAMAM alone did not work well. The novel PAMAM + NACP bonding agent method is promising to improve the longevity of resin-dentin bonds, inhibit caries, and protect teeth. - Highlights: • PAMAM induced moderate remineralization for dentin in artificial saliva/lactic acid. • Acid challenge reduced the effectiveness of dentin remineralization via PAMAM. • NACP bonding agent had acid-neutralization and Ca and P ion release capabilities. • Novel PAMAM + NACP achieved the greatest remineralization of pre-demineralized dentin. • PAMAM + NACP restored hardness of pre-demineralized dentin to that of healthy dentin.