Dentaltown August 2017 - 73
Jefferies, et al., further illustrated that
GICs do not form apatite. This study did,
however, illustrate that two bioactive calciumbased materials, calcium aluminate and
calcium silicate, stimulate apatite formation
and could seal or reseal artificially created
gaps in simulated aqueous physiological
conditions. The clinical significance of
these types of calcium containing bioactive
materials is that they can improve the
marginal stability of the tooth/restorative
material interface and the long-term survival
and serviceability of the restorations.15
Biomineralization is a process by
which living organisms secrete inorganic
materials in an organized manner.16 Or,
put another way, it's how the structure and
properties of inorganic solids are deposited
in biological systems. This occurs via the
selective extraction and uptake of elements
from the local environment and their
incorporation into functional structures
under strict biologic control.
The biomineralization process requires
crystalline structures with specific ionic
properties and of the appropriate size to organize and form biologic apatite. Essentially,
if the proper building blocks are provided
and water is present, remineralization can
occur. Calcium and phosphate ions, along
with water, are the essential components
for this natural remineralization process.
Sauro and Pashley report the most
recent research suggests amorphous (noncrystalline) calcium phosphate (ACP) enters
collagen fibrils in a biomimetically stabilized
"fluidic" state."17 Research by Abuna, et al.,
illustrates that when demineralized dentin
is covered with a flowable resin composite
that contains ACP and is immersed in
biomimetic polyanions, the calcium and
phosphate ions can slowly diffuse through any
water-filled porosities within adhesives and
hybrid layers.18 The investigators concluded
that it would be possible to "backfill" such
defects with apatite crystals and fossilize
all dentin proteases as the matrix collagen
remineralizes. This approach decreased
nanoleakage and showed phosphate uptake
and deposition of needlelike crystallites at
the intrafibrillar level.
Discussion
How do we translate this science into
clinical applications? Currently, there are several
types of restorative materials for use in clinical
dentistry that meet the criteria for bioactivity.
They are dynamic materials that transport
water and, in the presence of saliva, stimulate
the formation of apatite at the restorative/tooth
interface. To act as an amalgam and composite
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73
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Table of Contents for the Digital Edition of Dentaltown August 2017
Dentaltown August 2017 - Intro
Dentaltown August 2017 - Cover1
Dentaltown August 2017 - Cover2
Dentaltown August 2017 - 1
Dentaltown August 2017 - 2
Dentaltown August 2017 - 3
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Dentaltown August 2017 - Cover3
Dentaltown August 2017 - Cover4
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