Dentin caries progression and the role of metalloproteinases: an update

Authors:

ABSTRACT

Aim

This review aims to summarise our understanding of the destructive role of acid environment and metalloproteinases in
dentin caries progression using a review process. METHOD: The acids resulting from consumption of sugars by acidogenic and aciduric
bacteria can cause demineralisation of the tooth surface, but are not able to cause caries-like lesions. The appearance of such lesions
requires the activation of enzymatic proteolysis in an acidic environment for degradation of the dentin organic matrix, leading to cavity
formation. Bacterial collagenases have long been considered responsible for organic matrix destruction; host cell-derived matrix
metalloproteinases (MMPs) have recently been considered to be involved in the dentinal matrix destruction of carious lesions.
DISCUSSION AND

Conclusion

MMPs are initially synthesised as inactive zymogens to be activated in acid environment of dentinal
fluid during the carious process, resulting in destruction of the collagenous matrix. The role of acid environment on enamel and dentin
demineralisation and the role of salivary and dentinal MMPs in dentin progression of caries has encouraged general dentists to include
the monitoring of oral environment not only by control of bacterial oral flora in caries treatment protocol, but mainly by inhibition of
dentinal and salivary MMPs through the use of toothpaste and/or mouthwash containing specific active agents.

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