Background: Tooth enamel is a non-living tissue, once matured it can no longer remineralization itself. Unfortunately, there are only a few studies that analyze the risks and benefits in applications towards remineralization. The objective was to examine the effectiveness and risks of synthetic applications towards remineralizing tooth enamel.
Methods: Experimental trials focusing on the effect of synthetic applications on tooth enamel such as, surface hardness, surface thickness and overall effectiveness were included in this review. Published articles from 1978 to 2018 were identified using specific keywords terms in the ScienceDirect and PubMed database. Each study was independently screened to meet eligibility and asses risk of bias, if any.
Results: Seven experimental reports applying three synthetic methods: Ca/PI ratios of stimulated saliva, Nano-hydroxyapatite and Calcarea Fluorica tablets were evaluated. Application process and outcomes varied throughout each study. Ca/PI ratios of stimulated saliva did not affect the remineralization process significantly (P > 0.5) and was associated with no harms on the molars used. Studies evaluating the use of synthetic nano-hydroxyapatite displayed statistically significant (P < 0.5) outcomes towards remineralization increasing surface hardness and thickness. One study analyzed the effects of Calcarea Fluorica tablets reporting the most overall increase in remineralization but mostly towards surface hardness, as well as being statistically significant (P < 0.5).
Conclusion: Studies were limited and short term, leaving room for error and miscalculation. However, there is data that expresses overall positive effects towards remineralization. The results show a need for future experimental trials on synthetics to get a better understanding in this area.

Key Words: Tooth Enamel, Remineralization, Demineralization, Erosion and Lesion Caries.