Acquired Enamel Pellicle Engineering and the Use of Vitamin E as a Preventive Strategy for Dental Erosion

INTRODUCTION/OBJECTIVE: Dental erosion is a multifactorial condition in which early demineralization events occur at the enamel-environment interface, highlighting the relevance of the acquired enamel pellicle (AEP) as a biological modulator of erosion susceptibility. This narrative review aimed to synthesize current biochemical and experimental evidence on AEP engineering as a preventive strategy against dental erosion, with particular emphasis on the role of vitamin E as a lipophilic modulator of the pellicle organic matrix. DATA AND SOURCES: A structured narrative review was conducted following SANRA guidelines. Electronic searches were performed in PubMed/MEDLINE, Scopus, Embase, and Web of Science up to January 2026. In vitro, in situ, ex vivo, and in vivo studies, as well as relevant reviews addressing AEP composition, pellicle engineering strategies, interfacial biochemistry, and erosion-related outcomes were included. RESULTS: Four experimental studies were identified. The studies used bovine or human enamel specimens exposed to lipid-based formulations containing α-tocopherol, alone or combined with bioactive compounds such as proanthocyanidins or cystatins. AEP formation protocols involved either pooled human saliva or in situ pellicle formation, followed by erosive challenges with citric acid. Across studies, surface microhardness and surface reflection analyses consistently suggested that Vitamin E-containing formulations enhance the protective properties of the AEP and reduce enamel demineralization. CONCLUSION: The evidence supports the concept of the AEP as a dynamic and modifiable biointerface capable of influencing enamel resistance to erosive challenges. Vitamin E, particularly α-tocopherol, does not appear to act as a direct protective agent but rather function as an interfacial modulator, interacting transiently with lipid domains and hydrophobic regions of pellicle proteins. CLINICAL SIGNIFICANCE: Vitamin E-based acquired enamel pellicle engineering represents a promising adjunctive strategy for reducing initial enamel erosion through modulation of interfacial physicochemical properties rather than direct mineral reinforcement.