Direct restoration of erosive tooth wear using biomimetic composite and ultrafast laser processing: An in-situ study

The prevalence of irreversible erosive tooth wear (ETW) results in progressive loss of tooth surface, leading to compromised chewing and mastication functions. The study evaluates the restorative efficacy of a bio-composite for treating the ETW. The in vitro and in situ experiments focused on evaluating the biocompatibility of a laser-assisted bio-composite restoration for eroded enamel surfaces and its potential for in situ saliva remineralisation. The bio-composite was formulated by mixing Fe³⁺ doped fluorapatite (FAP) with chitosan hydrogel for restoring artificially created ∼ 70 μm deep eroded human enamel lesion. The surface of the restored lesion was then irradiated with a 1040 nm ultrafast laser to densify the material and enhance its bonding with the vicinal healthy enamel. The in-situ appliance study of in-vitro restored lesion was conducted in the selected healthy volunteer’s mouth to ascertain and compare the statistical efficacy with the acid-resistant properties of natural human enamel as a control. The in-situ evaluation study demonstrated that the use of ultrafast laser-assisted bio-composite restores lesions and has the potential to prevent further acid erosion. This study also reveals a conceptual remineralisation strategy for effective enamel repair in clinical practices. It offers potential insights into the mechanisms of biomineral formation, thus preventing enamel erosion, which might be implemented for the restoration of human and pet animal tooth wear.