Analysis of efficacy of the self‐assembling peptide‐based remineralization agent on artificial enamel lesions

Üstün, Nilüfer; Aktören, Oya

doi:10.1002/jemt.23254

Cited by 30 publications

(27 citation statements)

References 35 publications

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“…On the other hand, although the fluorescence loss and lesion area were decreased linearly, Duraphat did not significantly differ in enamel remineralization at 7, 14, and 21 days from the baseline. Since this result also supports previous researches [6,23] that showed the low remineralization potential of the Duraphat varnish for the longer duration, conventional fluoride varnish can be recommended to be applied more frequently.…”

Section: Discussionsupporting

confidence: 89%

“…The changes in the samples of the control group from baseline to day 21 suggest that some natural remineralization of WSLs occurred. Previous studies [23,25] determined that the artificial saliva solution, which is frequently used as a negative control group in in vitro studies, displayed remineralizing potential for WSLs. Therefore, the decrease in fluorescence loss and lesion area can be contributed to the daily renewal of the artificial saliva at pH range between 6.5 and 6.8 throughout the whole present trial.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies [8,11,23] comparing the remineralization activities of fluoride-containing agents also suggest Curodont as it represents the superior efficacy. In the two different in vitro studies [23,26], selfassembling peptide P 11-4 resulted a significant change in the fluorescence values at the 7th day, and an in vivo study carried out by Brunton et al [27] showed similar findings of the remineralization in the lesion area from the 8th day. The mechanism of the self-assembling peptide P 11-4 for the treatment of WSLs can be explained by the formation of de novo hydroxyapatite crystals.…”

Section: Discussionmentioning

confidence: 99%

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Comparative evaluation of fluoride varnishes, self-assembling peptide-based remineralization agent, and enamel matrix protein derivative on artificial enamel remineralization in vitro

Sezici¹,

Yetkiner

Yetkıner

et al. 2021

Prog Orthod.

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Background One of the most unfavorable side effects of fixed orthodontic treatment is white spot lesions (WSLs). Although the most important approach is prevention of WSLs, it is also essential to evaluate the efficacy of the remineralization agents. However, there is no concurrence in the literature with respect to the remineralization process of these agents. The objective of the present study was to evaluate the effects of different fluoride varnishes, enamel matrix protein, and self-assembling peptide derivatives with varying chemical compositions on remineralization of artificially created WSLs in vitro using quantitative light-induced fluorescence (QLF). Methods Artificial WSLs were created on bovine enamel samples using acidic buffer solution (pH 5, 10 days). Specimens were randomly allocated to six groups (n = 10/group): (1) Emdogain (Straumann, Basel, Switzerland), (2) Curodont Repair (Credentis AG, Switzerland), (3) Duraphat (Colgate-Palmolive, New York, NY), (4) Clinpro XT (3 M ESPE, Pymble, New South Wales, Australia), (5) Enamel Pro Varnish (Premier Dental Products, PA, USA), and (6) control (untreated). The agents were applied to the WSLs according to the manufacturers’ instructions. Fluorescence loss (ΔF), lesion area (area), and impact (ΔQ) values of enamel surfaces were quantified by QLF-D BiluminatorTM (Inspektor-Pro, Amsterdam, The Netherlands) at baseline and after 7, 14, and 21 days of application of the respective materials. Results ΔF value presented a significantly decreasing trend throughout the 21 days for all groups except the Duraphat and Enamel Pro varnishes. The changes between 14th and 21st days of the Clinpro XT varnish application were significantly higher than Emdogain, Curodont, and Enamel Pro. The Curodont group showed higher lesion area changes between the first and second week in comparison to the Emdogain, Clinpro XT, and Enamel Pro groups, whereas Clinpro XT assured the highest reduction from the second to the third week of the observation period. Conclusions The fluorescence loss was significantly reduced with enamel matrix protein, self-assembling peptide, and light-curable fluoride varnishes in the analysis for 21 days. Curodont and Clinpro XT were effective in diminishing the fluorescence loss and lesion area compared to the Duraphat, Enamel Pro fluoride varnishes, and Emdogain in different time points.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparative evaluation of fluoride varnishes, self-assembling peptide-based remineralization agent, and enamel matrix protein derivative on artificial enamel remineralization in vitro

Sezici¹,

Yetkiner

Yetkıner

et al. 2021

Prog Orthod.

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“…For SAP P 11 -4 to be translated into daily clinical practice, it is essential that clinicians can visualize the treatment effect with available diagnostics. Both ex vivo and in vivo studies have reported the successful use of laser fluorescence, PTR-LUM, Impedance, QLF and radiography in monitoring remineralization after SAP P 11 -4 application in a time-dependent manner 12,13,[16][17][18][19][20] .…”

mentioning

confidence: 99%

Randomized Clinical Trial investigating Self-Assembling Peptide P11-4 for Treatment of Early Occlusal Caries

Doberdoli

Bommer

Begzati

et al. 2020

Sci Rep

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Non-invasive caries treatment is a major focus in modern dentistry. The present study was designed to evaluate the effectiveness of monomeric self-assembling peptide P 11-4 (SAP P 11-4) in combination with fluoride varnish or polymeric self-assembling peptide matrix (SAPM) in treatment of non-cavitated occlusal caries. Ninety children and adolescents were included in this randomized, gold-standardcontrolled clinical trial. Test Group 1 received SAP P 11-4 and twice fluoride varnish at baseline and Day 180, Test Group 2 received SAP P 11-4 on baseline and twice weekly SAPM (home-application), and Control Group received fluoride varnish on baseline and Day 180. Caries progression was measured by laser fluorescence, Nyvad Caries Activity, ICDAS-II-codes, and investigator assessments. Laser fluorescence changes demonstrated superior results for Test Group 1 and 2, as values decreased compared to an increase for the Control Group (p < 0.0005). ICDAS-II codes at Day 360 showed partial regression for Test Group 1 (6.7%) and Test Group 2 (20.0%) and partial progression for Control Group (23.3%) (p < 0.01). Nyvad Caries Activity yielded superior caries inactivation for Test Groups, compared to Control Group (p = 0.002). This trial showed that SAP P 11-4, applied either in combination with fluoride varnish or twice weekly SAPM, was a superior treatment for early caries compared to fluoride varnish alone. Caries levels have significantly decreased over the past decades, partially due to the introduction of fluoride in various forms 1. However, despite the promising efforts and results worldwide, caries levels have remained high, and caries is still the most common disease worldwide 2. Recent efforts to lower caries levels have focused on treating early carious lesions non-invasively, as there is consensus that only early intervention, prior to cavitation, can lead to a regression of the caries to a more healthy state 3,4. Novel therapeutics have been called for, and promising approaches are based on biomimetic research and development. Biomimetic concepts fall into two categories, either based on amelogenin or derivatives thereof, or on rationally designed and screened systems 5,6. There is substantial research in the field, yet most of it is in vitro-based. The exceptions are recent clinical investigations of the rationally designed self-assembling peptide P 11-4 applied either in its monomeric form (SAP P 11-4) 5,6 or its polymeric form as a self-assembled peptide matrix (SAPM). This is the first clinical trial investigating the combined effect of SAP P 11-4 and SAPM in treatment of early carious lesions. SAP P 11-4 has been systematically investigated 7. The self-assembling peptide was rationally designed to provide favourable physicochemical characteristics for nucleation of hydroxyapatite (HA) on the surface of the formed fibres of the 3D matrix 8,9. The mechanism of action of SAP P 11-4 in the remineralization of enamel was proposed early on and has been proven since 10,11. When monomeric SAP P 11-4 is applied onto th...

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“…This β-sheet forming self-assembling peptide possesses anionic groups in the side chains that attract Ca 2+ ions, diffuses well into the body of the caries lesions due to its low viscosity, and triggers self-assembly within the lesion inducing the precipitation of HA in situ. A single application of P11-4 improves the appearance of white spot lesions after 180 days in a small-scale clinical study (Alkilzy et al, 2018a;González-Cabezas and Fernández, 2018;Arifa et al, 2019;Jablonski-Momeni et al, 2019;Üstün and Aktören, 2019;Kamal et al, 2020;Li et al, 2020). However, more evidence is still needed before this peptide can be used in caries prevention and regular therapy (Alkilzy et al, 2018a;González-Cabezas and Fernández, 2018;Arifa et al, 2019;Jablonski-Momeni et al, 2019;Üstün and Aktören, 2019;Kamal et al, 2020;Li et al, 2020).…”

Section: Self-assembled Peptidesmentioning

confidence: 99%

Bioactive Synthetic Peptides for Oral Tissues Regeneration

et al. 2021

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Regenerative therapy in oral tissues has gained relevance since tissue loss due to congenital or acquired diseases as well as trauma is a major health problem worldwide. Regeneration depends on the natural capacity of the body and the use of biomaterials and bioactive molecules that can module the processes to replace lost or damaged tissues and restore function. The combined use of scaffolds, cells, and bioactive molecules such as peptides is considered the best approach to achieve tissue regeneration. These peptides can induce diverse cellular processes as they can influence cell behavior and also can modify scaffold properties, giving as a result the enhancement of cell adhesion, proliferation, migration, differentiation, and biomineralization that are required given the complex nature of oral tissues. Specifically, synthetic peptides (SP) have a positive influence on scaffold biocompatibility since in many cases they can mimic the function of a natural peptide or a full-length protein. Besides, they are bioactive molecules easy to produce, process, and modify, and they can be prepared under well-defined and controlled conditions. This review aims to compile the most relevant information regarding advances in SP for dental and periodontal tissue regeneration, their biological effects, and their clinical implications. Even though most of the SP are still under investigation, some of them have been studied in vitro and in vivo with promising results that may lead to preclinical studies. Besides there are SP that have shown their efficacy in clinical trials such as P11-4 for enamel regeneration or caries prevention and ABM/P-15 for cementum, periodontal ligament (PDL), and alveolar bone on a previously calculus- and biofilm-contaminated zone. Also, some SP are commercially available such as PTH1-34 and PepGen P-15 which are used for bone defects treatment.

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Analysis of efficacy of the self‐assembling peptide‐based remineralization agent on artificial enamel lesions

Cited by 30 publications

References 35 publications

Comparative evaluation of fluoride varnishes, self-assembling peptide-based remineralization agent, and enamel matrix protein derivative on artificial enamel remineralization in vitro

Comparative evaluation of fluoride varnishes, self-assembling peptide-based remineralization agent, and enamel matrix protein derivative on artificial enamel remineralization in vitro

Randomized Clinical Trial investigating Self-Assembling Peptide P11-4 for Treatment of Early Occlusal Caries

Bioactive Synthetic Peptides for Oral Tissues Regeneration

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