Treatment of Carious Lesions Using Self-Assembling Peptides

Alkilzy, Mohammad; Santamaría, Ruth M.; Schmoeckel, Julian; Splieth, Christian H.

doi:10.1177/0022034517737025

Cited by 68 publications

(59 citation statements)

References 37 publications

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“…However, if future in vivo studies can confirm the clinical promise of 8DSS and overcome the challenges, it holds great promise as non-fluoride biomineralizing agent . Self-Assembling P11-4 Peptides An ideal enamel regenerative approach would involve substituting the degraded enamel matrix with a biomimetic matrix that favours in-depth remineralization of enamel lesions [Alkilzy et al, 2018a]. An exciting development in this field is a monomeric peptide consisting of 11 amino acids called P11-4.…”

Section: Biomimetic Remineralizationmentioning

confidence: 99%

“…This includes the ability to reverse early occlusal and proximal lesions that are more resistant to fluoride remineralization than smooth surface lesions [Alkilzy et al, 2018a[Alkilzy et al, , 2015Brunton et al, 2013;Schlee et al, 2014Schlee et al, , 2018. The low viscosity isotropic P11-4 when applied on the initial carious lesion rapidly diffuses into the lesion body, where it transforms to an elastomeric nematic gel in the presence of cations and pH < 7.4, leading to the 3-dimensional fibre matrix assembly and subsequent biomineralization of the lesion [Brunton et al, 2013].…”

Section: Biomimetic Remineralizationmentioning

confidence: 99%

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State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management

2018

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The principles of minimally invasive dentistry clearly dictate the need for clinically effective measures to remineralize early enamel caries lesions. While fluoride-mediated remineralization is the cornerstone of current caries management philosophies, a number of new remineralization strategies have been commercialized or are under development that claim to promote deeper remineralization of lesions, reduce the potential risks associated with high-fluoride oral care products, and facilitate caries control over a lifetime. These non-fluoride remineralizing systems can be broadly categorized into biomimetic enamel regenerative technologies and the approaches that repair caries lesions by enhancing fluoride efficacy. This paper discusses the rationale for non-fluoride remineralization and the mechanism of action, challenges, and evidence behind some of the most promising advances in enamel remineralization therapies.

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Section: Biomimetic Remineralizationmentioning

confidence: 99%

Section: Biomimetic Remineralizationmentioning

confidence: 99%

State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management

2018

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“…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 (SAP P 11 -4) 21 .The mode of action for the treatment of initial caries with SAP P 11 -4 is as follows 23,24 .…”

mentioning

confidence: 99%

“…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 (SAP P 11 -4) 21 .…”

mentioning

confidence: 99%

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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“…An ideal enamel regenerative approach would involve substituting the degraded enamel matrix with a biomimetic matrix that favours in-depth remineralization of enamel lesions [Alkilzy et al, 2018]. An exciting development in this field is a monomeric peptide consisting of 11 amino acids called P11-4.…”

Section: Self-assembling P11-4 Peptidesmentioning

confidence: 99%

Ecological approaches to dental caries prevention: Alteration of biofilms by natural products and casein-phosphopeptide-amorphous calcium phosphate

Philip¹

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Background: Dental caries is today widely recognised to be a biofilm-mediated disease triggered by dysbiosis in the resident oral microbiome. Despite the evolution of caries aetiological theories, disease preventive strategies are still largely dependent on the physicochemical effects of fluoride on the demineralization-remineralization caries equilibrium. The inability of fluoride to significantly influence the cariogenic bacterial challenge and reverse the microbial dysbiosis is one of the reasons the disease persists in many high caries-risk individuals and population groups. Countering the microbiome dysbiosis with conventional oral microbiocides is not recommended as their broadspectrum antimicrobial effects will eliminate even health-associated plaque microflora. Comprehensive caries management protocols need to encompass agents that not only influence the de-/remineralization balance, but also include measures that can have a beneficial modulating effect on the ecology of the dental plaque microbiome. Objectives: The overall aims of this PhD project were to examine whether selected natural products and novel remineralizing agents like casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) can disrupt key virulence properties of cariogenic bacteria without broadly affecting microbial viability. The study also aimed to explore whether any virulence inhibitory effects of cariostatic natural products and CPP-ACP could translate into beneficial ecological effects both in in vitro biofilm models and in a clinical environment. Methods: A literature review was performed to identify natural products with potential cariostatic effects for investigation in this study. Agar diffusion and broth microdilution assays were used to assess whether any of the selected natural products could inhibit the growth of planktonic cultures of a caries-associated bacteria species (Streptococcus mutans) without affecting the viability of a healthassociated oral commensal bacterial species (Streptococcus sanguinis). Based on the results of the planktonic bacterial culture study, specific natural products were further selected to explore their effects on cariogenic biofilm virulence properties. The biofilm studies were conducted in an active attachment in vitro model using monospecies S. mutans biofilms, dual-species S. mutans-Candida albicans biofilms, and saliva-derived polymicrobial biofilms growing in a cariogenic environment. The natural products were assessed for their effects on biofilm metabolic activity, acidogenicity,

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Treatment of Carious Lesions Using Self-Assembling Peptides

Cited by 68 publications

References 37 publications

State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management

State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management

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

Ecological approaches to dental caries prevention: Alteration of biofilms by natural products and casein-phosphopeptide-amorphous calcium phosphate

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