Comparative evaluation of remineralizing efficacy of biomimetic self-assembling peptide on artificially induced enamel lesions: An <i>in vitro</i> study

Kamal, Dina; Hassanein, Hassan; Elkassas, Dina; Hamza, Heba

doi:10.4103/jcd.jcd_123_18

Cited by 18 publications

(12 citation statements)

References 22 publications

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“…Critical clinical assessment factors such as the hardness and gloss of the lesion could not be taken into account as they could not be measured reliably within an in vivo study. It would be interesting to measure the enamel hardness induced by SAP P 11 -4, and compare those to the previously reported in vitro microhardness results 34,35 .…”

Section: Discussionmentioning

confidence: 87%

“…exhibited a substantial decrease of impedance readings throughout the study period (Table 1). Control teeth showed a mean baseline value of 42.0 at day 0, which decreased to 35.0 at day 45,29.5 at day 90, and 33.7 at day 180. Test teeth showed a mean baseline value of 46.7 and exhibited a markedly larger decrease to 21.1 (day 45), 18.4 (day 90), and 19.7 (day 180).…”

Section: Impedance Measurement Of White Spot Lesion (Primary Endpointmentioning

confidence: 95%

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Effect of self-assembling peptide P11-4 on orthodontic treatment-induced carious lesions

Welk

Ratzmann

Reich

et al. 2020

Sci Rep

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This study aimed to evaluate the effect of self-assembling peptide P 11 -4 (SAP) in the therapy of initial smooth surface caries (white spot lesions, WSL) following orthodontic multibracket treatment. Twentythree patients (13f/10m; average age 15.4 years) with at least two teeth with WSL were recruited for the randomised controlled clinical trial with split-mouth design. In opposite to the control teeth, the test teeth were treated with SAP on Day 0. The primary endpoint was the impedance measurement of WSL using customised tray to ensure reproducibility of the measurement location. The secondary endpoint was the morphometric measurement of WSL using a semi-automated approach to determine the WSL size in mm 2 . Treatment effects were adjusted for site-specific baseline values using mixed models adapted from the cross-over design. Test WSL showed a mean baseline impedance value of 46.7, which decreased to 21.1, 18.4, and 19.7 after 45, 90, and 180 days, respectively. Control WSL showed a mean baseline value of 42.0, which decreased to 35.0, 29.5, and 33.7, respectively. The overall treatment contrast was −13.7 (95% CI: −19.6 -−7.7; p < 0.001). For the secondary endpoint, the test WSL size decreased from 8.8 at baseline to 6.5 after 180 days. The control WSL decreased from 6.8 to 5.7, respectively. The related treatment contrast was −1.0 in favour of test WSL (95% CI: −1.6 -−0.5; p = 0.004). The treatment of initial carious lesions with self-assembling peptide P 11 −4 leads to superior remineralisation of the subsurface lesions compared with the control teeth.Orthodontic treatments with fixed multibracket appliances hindering oral hygiene, support plaque accumulation, and caries progression 1,2 . These orthodontic treatment-induced carious lesions are typically visible first as so-called white spot lesions (WSL) on the buccal surface of the tooth outlining the brackets 3-6 .Modern treatment concepts for caries emphasise tooth preservation and remineralisation concepts especially for initial non-cavitated carious lesions, in order to hinder or to delay the first invasive intervention, meaning destruction of the natural tooth structure 7 .Unique for buccal WSL is the addition of an aesthetic component to the cariological issue 3,8 . Fluorides prevent the formation of so-called white spot lesions (WSL) but have shown little effect on the reduction of existing WSL 9-11 . As their effect is restricted to the outer surface layer of the enamel (i.e. top 50 µm) and does not promote the remineralisation throughout the demineralised lesion body. The WSL persist visually almost unchanged 12-14 . Other remineralisation agents, often based on calcium phosphate, have been investigated, but could not show clinically significant advantage over fluoride 10,11,[15][16][17] .As a consequence, new treatment approaches have been called for and biomimetic mineralisation seems to be one promising possibility [18][19][20][21][22] . However, the only clinically available products at present are based on the self-assembling peptide P 11 -4 ...

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Section: Discussionmentioning

confidence: 87%

Section: Impedance Measurement Of White Spot Lesion (Primary Endpointmentioning

confidence: 95%

Effect of self-assembling peptide P11-4 on orthodontic treatment-induced carious lesions

Welk

Ratzmann

Reich

et al. 2020

Sci Rep

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“…Recently, a rationally designed monomeric self-assembling peptide P 11 -4 (SAP P 11 -4) solution 9 , which is able to diffuse into the subsurface carious lesions and self-assembles into a 3D biomimetic scaffold within, can guide the remineralization process 10,11 . SAP P 11 -4 has been shown to diffuse into the body of the carious lesion, and supporting de novo hydroxyapatite formation below the porous mineralized surface [11][12][13][14] . A first in man clinical trial has shown that SAP P 11 -4 is safe for human use and can reverse caries progression, significantly reducing the size of buccal white spot lesions as assessed by a visual analogue scale 15 .…”

mentioning

confidence: 86%

Efficacy of P11-4 for the treatment of initial buccal caries: a randomized clinical trial

Kondelova

Mannaa

Bommer

et al. 2020

Sci Rep

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To investigate the safety and efficacy of Self-Assembling Peptide P11-4 (SAP P11-4) compared to placebo or fluoride varnish (FV), a randomized, controlled, blinded, split-mouth study with sequential design was conducted. Subjects presenting two teeth with White-Spot-Lesions (WSLs) were included and teeth were randomly assigned to test or control. Control received placebo at baseline (D0) and test SAP P11-4, all received FV at Day 90 (D90). Standardized photographs were taken at each visit, and WSL size changes were morphometrically assessed. Hierarchical Linear Modelling, considering paired and sequential design, was used to test four hypotheses. SAP P11-4 lesions (test, D90–D0) showed significant WSL size reduction compared to placebo (control, D90–D0; p = 0.008) or FV (control, D180–D90; p = 0.001). Combination of SAP P11-4 and delayed FV after 90 days (test, D180–D0), showed a significant difference compared to FV alone (control D270–D90; p = 0.003). No significant difference on FV efficacy was found when SAP P11-4 was applied 3 months before FV (test D270–D90; control D270–D90, p = 0.70). SAP P11-4 treatment resulted in superior caries regression compared to either placebo or FV, and FV efficacy seems not to be affected by SAP P11-4. SAP P11-4 was found to be a safe and effective WSL treatment.

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“…A variant of CPP-ACP known as biomimetic self-assembling peptide (P11-4) has shown significantly high remineralising efficacy compared to topical fluorides and CPP-ACPF exhibiting its potential as a non-invasive enamel regenerative material. 26 These compounds have been recommended to be commercially added to foods, soft drinks and chewing gum, as well as in toothpastes and mouthwashes to control dental caries.…”

Section: Adverse Aspectsmentioning

confidence: 99%

Topical Fluorides for Head and Neck Cancer Patients Subjected to Surgical Resection and Radiation Therapy in Resource Restraint Settings

Sheikh

Khan

Tabassum

2020

J Coll Physicians Surg Pak

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Patients undergoing surgical resection and ionizing radiations for the treatment of head and cancer may lead a challenging life even after the cure of the disease; because these procedures can adversely affect the oral mucosa, salivary gland, bone, masticatory musculature, and the dentition. Especially, if major salivary glands are exposed to high dose radiation, an irreversible xerostomia may occur that can lead to rampant dental caries. Treatment of these complications demands high cost and time; and is often unaffordable for the patients in the resource constraint setting rendering them to compromise on their quality of life. The healthcare providers should work together in a team to prevent or manage these complications and improve the lives of the patients. This review paper focuses on the significance of low cost fluoride treatment for salvaging the dentition among patients who have had developed head and neck carcinoma and later got subjected to surgical resection and radiation therapy.

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Comparative evaluation of remineralizing efficacy of biomimetic self-assembling peptide on artificially induced enamel lesions: An in vitro study

Cited by 18 publications

References 22 publications

Effect of self-assembling peptide P11-4 on orthodontic treatment-induced carious lesions

Effect of self-assembling peptide P11-4 on orthodontic treatment-induced carious lesions

Efficacy of P11-4 for the treatment of initial buccal caries: a randomized clinical trial

Topical Fluorides for Head and Neck Cancer Patients Subjected to Surgical Resection and Radiation Therapy in Resource Restraint Settings

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