Kinetic and Thermodynamic Aspects of Enamel Demineralization

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Abstract
A model for subsurface lesion formation in dental enamel is presented that takes into account the known calcium phosphate chemistry and the transport processes occurring within the enamel and across the enamel surface-solution interface. The model, illustrated through the use of solubility diagrams (‘potential plots’), explains the presence of a relatively intact enamel layer overlying a zone of demineralization as a result of reprecipitation processes occurring within the enamel surface layer as dissolved ions, from beneath the surface, diffuse into the enamel surface and across the enamel surface-solution interface. Two conditions must be fulfilled, however, in order to form the intact layer. First that the rate at which ions diffuse across the enamel surface-solution interface does not exceed the rate of the envisioned reprecipitation processes. This rate is effectively controlled by the level of saturation of the demineralization media with respect to enamel mineral. The second requirement is that appropriate conditions are present within the enamel surface which support the reprecipitation processes. A working hypothesis is presented which states that demineralization solutions which support the formation of dicalcium phosphate dihydrate within the enamel surface will foster the formation of subsurface lesions under the appropriate kinetic conditions. The proposed model is noted to be consistent with experimental observations.

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