Antimicrobial, Remineralization, And Infiltration: Advanced Strategies For Interrupting Dental Caries

Dental caries, driven by biofilm-mediated demineralization, requires integrated strategies to restore structural integrity while controlling bacterial imbalance. Current biomimetic remineralization approaches inadequately mimic amelogenesis and lack synergy with antimicrobial technologies. This study introduces the "Interrupting Dental Caries" (IDC) concept, aiming to synergize amelogenesis-mimetic remineralization with antimicrobial action via a novel bifunctional amyloid hydrogel, PTB@CPC/ACP, to holistically arrest caries progression. The bifunctional PTB@CPC/ACP hydrogel combines antimicrobial cetylpyridinium chloride (CPC) and remineralizing amorphous calcium phosphate (ACP). It integrates three IDC pillars: antibacterial activity, biomimetic mineralization (emulating enamel matrix protein functions), and high permeability for sealing demineralized surfaces. Performance was evaluated through in vitro antibacterial assays, mechanical testing, and micro-CT to assess infiltration depth and remineralization efficacy. In vivo experiments assessed biocompatibility and validity. PTB@CPC/ACP demonstrated potent antibacterial activity( >70%inhibition of biofilm adhesion), deep infiltration, and effective remineralization, restoring enamel-like crystallinity and mechanical properties. The hydrogel achieved seamless sealing of demineralized zones, preventing further lesion progression. In vivo biocompatibility and non-toxicity were confirmed, aligning with minimally invasive principles. The IDC strategy outperformed standalone antimicrobial or remineralization therapies in halting caries. This study establishes a paradigm-shifting IDC approach by unifying antimicrobial, remineralizing, and infiltrative technologies. The PTB@CPC/ACP hydrogel successfully bridges gaps in current strategies, offering a clinically translatable solution for caries management. By prioritizing biofilm homeostasis, structural regeneration, and material permeability, this work provides a blueprint for next-generation multifunctional caries-interrupting materials with global public health implications.