Abstract
OBJECTIVES: This study aimed to evaluate and compare the remineralization potential of plant-based Galla chinensis extract (GCE) with nanohydroxyapatite (nHAp), chicken eggshell-derived nHAp (CES nHAp), and fish scale-derived nHAp (FS nHAp), against casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), on early artificial enamel lesions in human premolars. MATERIALS AND METHODS: A total of 148 human premolar specimens were prepared and demineralized to simulate early enamel caries, with five intact samples serving as baseline controls. Among these, 48 samples underwent surface microhardness testing using the Vickers hardness test, 60 were analyzed for lesion depth using Polarized Light Microscopy (PLM), 30 for elemental composition using Energy Dispersive X-ray (EDX) spectroscopy, and 10 for surface morphology using Scanning Electron Microscopy (SEM). The specimens were randomly assigned into five groups: demineralized control, CPP-ACPF, GCE with nHAp, CES nHAp, and FS nHAp. A seven-day pH cycling regimen simulated the oral environment. Microhardness values before demineralization (SMH1), after demineralization (SMH2), and after remineralization (SMH3) were recorded to calculate percentage surface microhardness recovery (%SMHR). RESULTS: The GCE nHAp group exhibited the highest %SMHR and the shallowest lesion depth, with EDX confirming a significantly higher calcium-to-phosphorus ratio. SEM images revealed smoother, more uniform surfaces in this group. CES nHAp and CPP-ACPF demonstrated moderate remineralizing effects, while FS nHAp showed the least efficacy, with no significant difference from CPP-ACPF. CONCLUSIONS: GCE combined with nHAp was the most effective remineralizing agent, followed by CES nHAp and CPP-ACPF. These findings suggest that natural plant- and animal-derived biomaterials offer promising, biocompatible alternatives for non-invasive enamel caries management.