Nanotechnology applied to enamel remineralization: Advances, challenges, and perspectives

Abstract

Dental caries remains one of the most prevalent chronic diseases worldwide. The need for effective and safe alternatives to conventional fluoride-based therapies has positioned nanotechnology as an innovative paradigm in enamel remineralization. This study aimed to critically analyze and synthesize scientific evidence published between 2019 and 2025 on the efficacy, safety, and clinical prospects of nanotechnology-driven strategies for enamel remineralization. A systematic literature review was undertaken using PubMed, Scopus, and Web of Science. Eligible studies included randomized clinical trials, in situ and in vitro investigations, and systematic reviews. Clinical evidence indicates that toothpastes containing nanohydroxyapatite yield outcomes comparable to sodium fluoride in preventing early carious lesions while also conferring aesthetic benefits. Bioactive and mesoporous glasses have demonstrated substantial remineralizing potential in in vitro settings but still lack large-scale clinical validation. Amorphous calcium phosphate nanoparticles exhibit dual functionality, facilitating remineralization while exerting antibacterial effects, whereas silicate-based compounds have shown efficacy in repairing enamel surfaces following bleaching and erosive challenges. Likewise, graphene-derived materials are distinguished by their multifunctionality, with preliminary studies suggesting superior performance compared to other nanomaterials. Collectively, nanotechnology constitutes a promising armamentarium for enamel remineralization. While nanohydroxyapatite currently has the strongest clinical evidence and regulatory endorsement, other approaches warrant validation through multicenter trials and standardized protocols. The integration of biomimetic peptides and multifunctional nanocomposites may delineate the next generation of dental therapeutic strategies.