OICC Press Progress in Biomaterials 2194-0517 14 04 2025 12 30 Strontium-Containing Biomaterials in Dentistry: Mechanisms of Remineralisation and Clinical Translation - A Systematic Review 10.57647/pibm.2025.1404.06 EN Maryam Saeedullah Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia Nozimjon Tuygunov Faculty of Medicine, Kimyo International University in Tashkent, Tashkent 100001, Uzbekistan; Department of Restorative Dentistry, Faculty of Dentistry, Tashkent State Medical University, Tashkent, Uzbekistan Noor Azlin Yahya Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia https://orcid.org/0000-0002-5722-1280 Muralithran Govindan Kutty Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia Arief Cahyanto Department of Restorative Dentistry, College of Dentistry, Ajman University, Ajman, P.O. Box 346, United Arab Emirates; Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, P.O. Box 346, United Arab Emirates Hien Chi Ngo University of Western Australia Dental School, 35 Stirling Highway, 6009, Perth, Australia Journal Article 2025 12 30 Strontium has emerged as a promising component in biomaterials, enhancing remineralisation of dental hard tissues through ionic substitution, bioactivity, and modulation of apatite formation. It has been integrated into strontium-doped nano-hydroxyapatite, bioactive glasses, and fluorophosphates, each exploiting distinct structure–function mechanisms. This systematic review evaluates the efficacy of strontium-containing biomaterials for enamel and dentin remineralisation, with focus on physicochemical properties, mechanisms of action, and translational potential. A systematic review of in vitro studies was conducted, including strontium-enriched formulations applied to enamel and/or dentin. Outcomes included changes in surface microhardness (ΔSMH) and lesion depth. Owing to heterogeneity in designs, formulations, and measures, findings were synthesised narratively using SWiM (Synthesis Without Meta-analysis) guidelines. Twenty-one in vitro studies were identified; only one used a bovine tooth model, and no human clinical trials were found. Twelve reported >30% enamel ΔSMH improvement, with Sr-doped nano-hydroxyapatite achieving gains up to 45%. Sr-bioactive glass and Sr–fluoride hybrids reduced lesion depth by 15–25%, with several studies showing synergistic effects with fluoride. To conclude, strontium-based biomaterials show promising potential for enhancing enamel remineralization and caries prevention; however, current evidence is derived exclusively from in vitro studies. Well-designed in vivo clinical trials are therefore essential before these findings can be reliably translated into clinical practice.