Scientists from the University of Nottingham have achieved a major breakthrough in dental regenerative medicine by developing a protein-based gel that can rebuild tooth enamel, the body's hardest material that cannot naturally regenerate once lost. The innovative treatment could revolutionize dental care by enabling biological repair rather than artificial replacement of damaged teeth.
Novel Biomimetic Approach to Enamel Regeneration
The research team created a biomimetic elastin-like recombinamer (ELR) gel that forms a thin layer over teeth and recruits calcium and phosphate ions from saliva to build new enamel through epitaxial mineralization. When applied to teeth, the gel seeps into bone to patch holes and cracks while forming scaffolding that attracts ions to promote further mineral growth.
"When our material is applied to demineralized or eroded enamel, or exposed dentine, the material promotes the growth of crystals in an integrated and organized manner, recovering the architecture of our natural healthy enamel," said lead author Dr. Abshar Hasan, a postdoctoral fellow at the University of Nottingham.
The researchers engineered a tunable and resilient supramolecular matrix that imitates the structure and function of the enamel-developing matrix. This matrix remains stable when applied as a coating and can trigger epitaxial growth of apatite nanocrystals, recreating the microarchitecture of different anatomical regions of enamel.
Rigorous Laboratory Testing Demonstrates Superior Performance
The team conducted comprehensive testing using extracted human molars as an ex vivo model. They first etched enamel or dentine surfaces with acid to mimic different stages of tooth erosion, then applied a single coating of the ELR gel and allowed it to dry. The teeth were immersed in controlled mineralization baths replicating saliva's ionic environment for approximately 10 days.
Through electron microscopy, researchers confirmed that new apatite crystals grew seamlessly from underlying enamel or dentine, showing continuous lattice alignment invisible to the naked eye. Nanoindentation tests revealed that remineralized enamel was nearly identical to healthy enamel in mechanical properties.
Most remarkably, when subjected to simulated daily wear and tear—including continuous electric-toothbrush abrasion equivalent to about a year of brushing, plus chewing and grinding—the treated teeth demonstrated superior resistance to wear, fracture and acid attack compared to natural enamel. Tests in both artificial and real human saliva produced identical results.
Addressing Global Oral Health Crisis
The innovation addresses a massive global health challenge. According to the World Health Organization, an estimated 3.7 billion people worldwide have some form of oral disease, with enamel erosion being a major contributor to tooth decay. Current dental care cannot repair lost enamel, leading to chipped or cracked teeth and cavities that require artificial replacements.
Enamel erosion results from chemical and mechanical triggers including frequent consumption of acidic and sugary foods, tooth grinding, aggressive brushing, acid reflux and dry mouth. While fluoride treatments are important, they cannot repair already eroded enamel.
Clinical Translation and Commercial Development
"We are very excited because the technology has been designed with the clinician and patient in mind," said Professor Alvaro Mata, Chair in Biomedical Engineering & Biomaterials at Nottingham University. "It is safe, can be easily and rapidly applied, and it is scalable. Also, the technology is versatile, which opens the opportunity to be translated into multiple types of products to help patients of all ages suffering from a variety of dental problems associated with loss of enamel and exposed dentine."
The researchers have established startup company Mintech-Bio to commercialize the technology, with hopes of launching the first product next year. The treatment could be applied much like common fluoride treatment in dental offices.
Current Limitations and Future Development
The researchers acknowledge that results are preliminary, as tests were conducted ex vivo under controlled conditions. The ELR layer measured only a few micrometers thick—thinner than natural enamel—so long-term durability remains unknown. Further development and testing will be required before clinical implementation.
The study demonstrates the translational potential of the mineralizing technology for treating enamel loss in clinical settings, including enamel erosion and dental hypersensitivity. This innovation represents a promising pathway toward regenerative dentistry that could help patients worldwide suffering from enamel-related dental problems.
