Changing Concepts from Enamel Remineralization to Regeneration

Objectives: The development of dental caries is not a continuous unidirectional process of demineralization. Instead, it is a cycle of demineralization and remineralization with various stages being either reversible or irreversible. Once this dynamic equilibrium tips toward demineralization, the first sign of reversible white spot lesion occurs. Enamel once formed cannot be biologically repaired or replaced. Methods: Conventional caries management has long emphasized remineralization, using agents such as fluoride and calcium-phosphate systems to replenish minerals and arrest lesion progression. Results: However, this approach primarily restores mineral content superficially and does not reproduce the enamel’s native microstructure or mechanical resilience. Recent advances in dental materials and tissue engineering have shifted the focus toward regeneration, aiming to biologically restore the hierarchical organization of enamel and dentin. Techniques involving using bioactive peptides and nanohydroxyapatite based agents that hold promise for reconstructing tooth tissues that maintains the both structural and functional properties. Conclusions: This evolution from remineralization to regeneration marks a significant paradigm shift in preventive and restorative dentistry, moving closer to true biomimetic repair.