{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:54:43Z","timestamp":1776664483231,"version":"3.51.2"},"reference-count":99,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"<jats:p>\n                    Minimally invasive management of initial enamel caries focuses on strategies that promote subsurface remineralization while limiting fluoride exposure, particularly in children. Phosphate salts such as sodium trimetaphosphate (TMP), sodium hexametaphosphate (SHMP) and calcium glycerophosphate (CaGP) have therefore been incorporated into topical fluoride formulations as interfacial modifiers. This narrative review critically examines mechanisms, experimental evidence and clinical data on polyphosphate systems for early enamel carious lesions. Relevant literature from databases including PubMed, Scopus, Cochrane and ScienceDirect was reviewed, focusing on\n                    <jats:italic>in vitro<\/jats:italic>\n                    ,\n                    <jats:italic>in situ<\/jats:italic>\n                    and\n                    <jats:italic>in vivo<\/jats:italic>\n                    human studies including clinical trials evaluating TMP-, SHMP- or CaGP-containing products. Available evidence indicates that these salts adsorb to enamel, assemble ion-rich surface layers, modulate biofilm acidogenicity and favor deeper subsurface repair, with nano-sized forms amplifying these effects. Across toothpastes, gels and varnishes,\n                    <jats:italic>in vitro<\/jats:italic>\n                    and\n                    <jats:italic>in situ<\/jats:italic>\n                    studies suggest that several low-fluoride polyphosphate formulations may achieve mineral uptake comparable to conventional 1,100-ppm F products, when fluoride:polyphosphate ratios were kept within a favorable window. Available clinical trials, although few and heterogeneous, suggest caries reduction in children using low-fluoride toothpastes containing polyphosphate salts. Overall, polyphosphate systems may represent a relevant option for subsurface enamel remineralization in susceptible groups, while longer-term clinical evaluation is still needed.\n                  <\/jats:p>","DOI":"10.3389\/froh.2026.1801636","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:25:25Z","timestamp":1776662725000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Polyphosphate-based strategies in enamel remineralization: mechanisms, evidence, and clinical potential"],"prefix":"10.3389","volume":"7","author":[{"given":"Btissam","family":"Seffahi","sequence":"first","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, Mohammed V University","place":["Rabat, Morocco"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imane","family":"El Ouarti","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, Mohammed V University","place":["Rabat, Morocco"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fa\u00efza","family":"Abdallaoui","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, Mohammed V University","place":["Rabat, Morocco"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"B1","volume-title":"Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030","year":"2022"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1159\/000503309","article-title":"Terminology of dental caries and dental caries management: consensus report of a workshop organized by ORCA and cariology research group of 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