Remineralization effects of self‐assembling peptide P₁₁‐4 associated with three materials on early enamel carious lesions: An in vitro study

Abstract

The aim of this study was to assess the remineralization of enamel caries lesions using the self-assembling peptide P 11 -4 associated with different materials. Artificial early enamel lesions were prepared on 154 primary teeth. The samples were randomly divided into eight groups: (1) control, (2) P 11 -4, (3) fluoridate toothpaste (FT), (4) P 11 -4 + FT, (5) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), ( 6) P 11 -4 + CPP-ACP, (7) fluoridate bioactive glass toothpaste (BT), and (8) P 11 -4 + BT. The surface enamel microhardness (EMH) and energy-dispersive Xray spectroscopy (EDS) of the teeth were then measured at the baseline, after demineralization, and after 28 days of remineralization. The enamel surfaces were assessed by field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM). The data were analyzed with one-way analysis of variance (ANOVA) (p < .05).EMH after demineralization was significantly lower than the baseline value (p < .001).The interventions led to an enhanced percentage of EMH recovery (%REMH), which was higher in Groups 6 and 7. There was no significant difference between Groups 3 and 4. Groups 1 and 2 had the lowest %REMH. The mean calcium/phosphate weight percentage ratio of P 11 -4 was significantly lower than the others (p < .001).The FESEM and AFM images revealed mineral deposition on the eroded enamel and reductions in surface roughness in Groups 5 and 7.

Remineralization of Self-Assembling Peptide P11-4 and Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride on Caries-Like Lesions in Primary Teeth (In-Vitro Study)

“…This can be compensated by time when fibrillar network forms and minerals deposit to form enamel like structure with high mineral content. (28) These findings agree with the results of Sindura et al 2018 (27) who used EDX to compare Ca/P ratio between self-assembling peptide P11-4 and CPP-ACP. CPP-ACP had a significantly higher Ca/P ratio after 1-week and 1-month but after 3 months selfassembling peptide P11-4 was significantly higher due to gradual increase in Ca/P ratio over time.…”

“…These results come in agreement with previous studies. (27,36) All surfaces that were treated with remineralizing agent showed smaller pore size and smoother than negative control group. CPP-ACPF group showed globular arrangement of the minerals, a finding that was reported in other studies.…”

Effectiveness of Self-Assembling Peptide (P11-4) in Dental Hard Tissue Conditions: A Comprehensive Review

“…The mean calcium/phosphate weight percentage ratio of P11-4 was significantly lower than the others Enamel [29] Clinical study to investigate SAPM gel compared to 8% arginine and calcium carbonate toothpaste for treatment of dentin hypersensitivity Significant reduction of dentin hypersensitivity, with the patient questionnaire indicating higher patient satisfaction Dentin [51] Effect of P11-4 on non-cavitated initial proximal carious lesions 12 months after treatment Radiographic and digital subtraction analyses suggest that initial proximal carious lesions can regress after treatment with P11-4 Enamel [30] Re-hardening potential of enamel matrix derivatives (EMD) and self-assembling peptides in vitro A significant re-hardening up to 125 pm was observed Enamel [31] In vivo efficacy of self-assembling peptide P11-4 compared to placebo or fluoride varnish P11-4 treatment resulted in superior caries regression compared to either placebo or fluoride varnish Enamel [32] In vitro regeneration of enamel in natural early caries lesions and evaluated over 50 days by photothermal radiometry and luminescence P11-4 promoted the regeneration of early caries Enamel [33] Effect of P11-4 to remineralise artificial carious lesions in enamel in vitro using a 30-day pH cycling model through surface microhardness analysis and SEM P11-4 remineralised the enamel lesions more effectively, and SEM photomicrographs demonstrated either amorphous crystals or particles scattered on the surface or lines of remineralisation along the prismatic borders Enamel [35] Ultrasonography to evaluate the effect of the self-assembling peptide P11-4 on acid erosion prevention on bovine enamel P11-4 peptides on erosive lesions can improve remineralisation Enamel [53] Remineralising efficacy of NovaMin, CPP-ACP, silver diamine fluoride (SDF), and P11-4…”

“…Additionally, Memarpour et al, (2021) revealed P11-4 peptide treated primary teeth had the lowest percentage of surface enamel microhardness. In addition, the mean calcium/phosphate weight percentage ratio of P11-4 was significantly lower than the others (p < 0.001) [29]. Recently, a study by Wahba and colleagues reported on the inability of P11-4 peptide to remineralise caries in deciduous teeth [75].…”

Adhesion and whitening efficacy of P11-4 self-assembling peptide and HAP suspension after using NaOCl as a pre-treatment agent

“…The application of P11-4 improves the enamel microhardness [ 47 ]. The P11-4-HAP suspension may also be effective in the treatment of hypersensitive teeth.…”