Remineralization of natural early caries lesions in vitro by P<sub>11</sub>‐4 monitored with photothermal radiometry and luminescence

Silvertown, Joshua D; Wong, Bonny P. Y.; Sivagurunathan, Koneswaran; Abrams, Stephen H.; Kirkham, Jennifer; Amaechi, Bennett T.

doi:10.1111/jicd.12257

Cited by 54 publications

(35 citation statements)

References 25 publications

(55 reference statements)

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“…This prepositions them for nucleation of hydroxyapatite (Aggeli et al, 2003;Kind et al, 2017;Kirkham et al, 2007). Several approaches, in vitro and in vivo, have recently demonstrated the effectiveness of self-assembling peptide P11-4 in remineralizing early carious lesions as well as in preventing demineralization of enamel (Brunton et al, 2013;Ceci et al, 2016;Jablonski-Momeni and Heinzel-Gutenbrunner, 2014;Silvertown et al, 2017;Soares et al, 2017); however, none have investigated P11-4 on dentin surfaces. Thus, the current analysis was the first to evaluate the use of self-assembling peptide P11-4 as a pretreatment for demineralized dentin and its influence on the microtensile bond strength of two different adhesive systems.…”

Section: Discussionmentioning

confidence: 99%

Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents

Martins

Sousa

Castilho

et al. 2018

Journal of the Mechanical Behavior of Biomedical Materials

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Bonding to demineralized dentin of a diseased tooth has shown to be a significant clinical issue. This study evaluated the effect of 0.2% NaF-(NaF), MI Paste™-(CPP-ACP) and the self-assembling peptide 'P' (Ace-QQRFEWEFEQQ-NH) contained in Curodont™ Repair, have on microtensile bond strength-(µTBS) of two different adhesive systems (Adper™ Single Bond-(SB) or Clearfil™ SE Bond (CSE)) and wettability of demineralized dentin slices after remineralising agents were applied. The highest µTBS were found for the demineralized dentin-(DD) treated with CPP-ACP; both adhesives systems (p < 0.05) did not significantly difference from P treatment associated with SB, and also presented higher values than sound dentin-(SD/SB) (p < 0.01). DD treated with P associated with CSE did not differ from DD/CSE (p > 0.05). The NaF treatment associated with CSE recovered the bond strength values of SD/CSE and associated with CSE demonstrated lower µTBS than other groups, although significantly higher than DD (p < 0.05). P and CPP-ACP increased significantly the wettability of demineralized dentin (p < 0.05); etching acid improved wettability for all groups (p < 0.05), whilst NaF did not affect the wettability of demineralized dentin (p > 0.05). Morphological analysis of the dentin surface and dentin-resin interface revealed unique features of the applied remineralizing agent. The results indicated that self-assembling peptide P associated with SB and CPP-ACP associated with SB or CSE significantly enhanced the bond strength to demineralized dentin (p < 0.05). We conclude that by modifying the dentine surface and restoring conditions found on sound dentin, this can enhance the interfacial bonding.

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Section: Discussionmentioning

confidence: 99%

Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents

Martins

Sousa

Castilho

et al. 2018

Journal of the Mechanical Behavior of Biomedical Materials

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“…Clinically, the effectiveness of self‐assembling peptide P 11 ‐4 has been investigated ex vivo with carious diagnostics, and in a clinical safety trial treating class V carious lesions . The application of P 11 ‐4 on 15 carious lesions led to a significant reduction of the lesion size, and a reversal of the lesion activity toward remineralization within 30 days of the single application, as assessed on randomized clinical photographs by blinded assessors.…”

Section: Introductionmentioning

confidence: 99%

Clinical performance of self‐assembling peptide P₁₁‐4 in the treatment of initial proximal carious lesions: A practice‐based case series

Schlee

Schad

Koch³

et al. 2017

J of Invest & Clin Dent

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Aim: The aim of the present study was to investigate the clinical performance of selfassembling peptide P 11 -4 on non-cavitated initial proximal carious lesions 12 months after treatment. Methods:Twenty-six patients, aged between 18 and 65 years, with 35 carious lesions were included in this practice-based, uncontrolled, prospective case series. The opacity and size of the proximal lesions were evaluated visually at baseline and at day 360 using standardized single-tooth or bite-wing and digital-subtraction radiography.Pairwise evaluation of images was carried out in a randomized and blinded manner with respect to the time point.Results: Twelve months after treatment of the proximal carious lesions, the visual evaluation showed a predominant shift toward regression of the initial lesions.Radiographic assessment yielded regression of the caries in 17 of 28 cases; four of 28 were regarded as unchanged, and seven of 28 lesions showed progression of the carious lesion. Combined assessment of clinical radiographs and digital subtraction radiographs confirmed the radiographic assessment, with 20 of 28 lesions showing total or partial regression, four unchanged, and four progressing. Conclusion:Radiographic and digital subtraction analyses suggest that initial proximal carious lesions can regress after treatment with P 11 -4, but additional factors might influence the overall treatment outcome. K E Y W O R D Sbiomimetic, proximal caries, regeneration, remineralization, self-assembling peptide P 11 -4

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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] .…”

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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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Remineralization of natural early caries lesions in vitro by P₁₁‐4 monitored with photothermal radiometry and luminescence

Cited by 54 publications

References 25 publications

Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents

Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents

Clinical performance of self‐assembling peptide P₁₁‐4 in the treatment of initial proximal carious lesions: A practice‐based case series

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

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Remineralization of natural early caries lesions in vitro by P11‐4 monitored with photothermal radiometry and luminescence

Cited by 54 publications

References 25 publications

Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents

Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents

Clinical performance of self‐assembling peptide P11‐4 in the treatment of initial proximal carious lesions: A practice‐based case series

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

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Remineralization of natural early caries lesions in vitro by P₁₁‐4 monitored with photothermal radiometry and luminescence

Clinical performance of self‐assembling peptide P₁₁‐4 in the treatment of initial proximal carious lesions: A practice‐based case series