Caries Remineralization With Mineral-Loaded Starch Particles in Dissolvable Dental Strips

Objectives: Mineral-Loaded Cationic Starch Particles (MLCSPs) have been shown to target the subsurface of active caries lesions and release calcium and phosphate ions to promote remineralization. The potential of these particles in a dissolvable dental strip formulation for remineralization of caries lesions was evaluated under laboratory conditions.
Methods: Fluoride-Free MLCSPs were prepared in a dissolvable dental strip formulation to simplify product usability. Forty extracted human teeth (IRB exempt) were selected by a cariologist to have non-cavitated smooth surface caries lesions. Lesion porosity/activity was evaluated with LumiCare™ (LC) Caries Detection Rinse, and half of each eligible lesion was coated with an acid-resistant varnish. Teeth were randomly allocated into three treatment groups: DI Water negative control (n=10); 1000ppm fluoride from NaF in DI water model control (n=10); and MLCSP test group (n=20). Samples underwent a 20-day accelerated remineralization protocol with 4x daily treatment applications, immersion in artificial saliva with amylase, and a 4-hour demineralization challenge with aged lactic acid carboxymethyl cellulose gel. Following the incubation period, samples were re-evaluated with LC rinse, then scanned with micro-computed tomography (MicroCT). MicroCT scans were analyzed comparing lesion mineralization vs. depth segmentation (0-0.1mm, 0.1-0.25mm and 0.25-0.45mm depth segments) of treated vs. untreated lesion regions.
Results: Samples treated with MLCSP dissolvable dental strips demonstrated substantial remineralization, particularly in the lesion subsurface, compared to negative and fluoride controls (see Table). LC fluorescence was notably reduced for lesions treated with MLCSPs or fluoride control compared to negative control.
Conclusions: These results demonstrate the potential for fluoride-free MLCSPs in dissolvable dental strips as a remineralization treatment for non-cavitated carious lesions. Future work will evaluate remineralization of carious lesions using different treatment regimens in a clinical setting.