Biomimetic Remineralization of Carious Lesions by Self-Assembling Peptide

Abstract

Caries is the most common disease in the world. Great efforts have been undertaken for prevention and to identify a regenerative treatment solution for dental caries. Self-assembling β-sheet forming peptides have previously shown to form 3-dimensional fiber networks supporting tissue regeneration. In particular, the self-assembling peptide P-4 has shown potential in the treatment and prevention of dental caries. It has previously been shown that application of monomeric P-4 solution to early carious lesions can increase net mineral gain by forming de novo hydroxyapatite crystals. The hypothesis for the mode of action was that monomeric self-assembling peptide P-4 diffuses into the subsurface lesion body and assembles therein into higher order fibrils, facilitating mineralization of the subsurface volume by mimicking the natural biomineralization of the tooth enamel, and it remains within the lesion body as a scaffold built-in by the newly formed hydroxyapatite. The aim of the present study was to investigate the mechanism of action of the self-assembling peptide P-4 supporting mineralization of carious enamel. By various analytical methods, it could be shown that the self-assembling peptide P-4 diffuses into the subsurface lesion, assembles into higher formed aggregates throughout the whole volume of the lesion, and supports nucleation of de novo hydroxyapatite nanocrystals and consequently results in increased mineral density within the subsurface carious lesion. The results showed that the application of self-assembling peptide P-4 can facilitate the subsurface regeneration of the enamel lesion by supporting de novo mineralization in a similar mode of action as has been shown for the natural formation of dental enamel.

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

“…The greater difference between test and control lesions, however, occurred in the impedance values compared with that in the morphometric measurements, thereby confirming that SAP P 11 -4 acts predominantly by regenerating the mineral structure of the enamel of the lesion body and not just the surface 23,24 . Moreover, at the last study visit at day 180, the impedance values for test lesions indicated regression of caries into very outer enamel, whereas the impedance values for the control lesions indicated still caries throughout the whole enamel layer 31,33 , which agrees with previous data that fluoride (in the present study as fluoride-based professional prophylaxis paste and home care toothpaste) only acts in the top 30-50 µm of the enamel surface 13,14,34 .…”

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

“…This rationally designed peptide self-assembles into hierarchical 3-dimensional fibrillar scaffolds in response to local conditions such as high ionic strength and acidic pH found in the lesion body [Kirkham et al, 2007]. The P11-4 fibrillar matrix has a high affinity for Ca 2+ ions and acts as a nucleator for de novo HA formation resulting in remineralization of the lesion body [Kind et al, 2017;Kirkham et al, 2007]. Analysis of in vitro data showed that the presence of P11-4 fibres in the lesion body resulted in faster HA formation, yielding tangentially arranged needle-shaped crystals, with increased microhardness of the remineralized subsurface lesion [Schmidlin et al, 2016;Sousa et al, 2017;Takahashi et al, 2016].…”

Stimuli‐Responsive Supramolecular Hydrogels and Their Applications in Regenerative Medicine

“…In addition to temperature and metal ligation (as with Biogelx) triggered gelation, the physicochemical properties of the supramolecular hydrogels can be tuned to achieve various desirable properties. For instance, the ability of PuraMatrix and Curodont is under consideration as fillers for dental lesions due to their ability to undergo biomineralization, which can be influenced by both chemistry and hydrophobicity of the precursors . In essence, temperature‐responsive supramolecular hydrogels that can undergo biomineralization could guide enamel regeneration through de novo mineralization and growth.…”