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

Abstract

INTRODUCTION:The early stages of dental caries involve enamel demineralization which can be reversed. Attempts have been made to develop new materials to remineralize enamel. OBJECTIVES: To assess remineralizing effect of Self-assembling Peptide P11-4 and Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CPP-ACPF) in comparison to Sodium Fluoride varnish on early carious lesions in primary teeth. MATERIALS AND METHODS: Thirty-six sound-extracted primary anterior teeth were used. A 4x4mm window was made in the middle of the labial surface of each tooth. Teeth were subjected to artificial demineralization and then randomly allocated into 3 groups: Group I(5%NaF varnish), Group II(CPP-ACPF varnish) and Group III(P11-4). Teeth were sectioned longitudinally into two halves. One half was treated by the remineralizing agent, and the other was left untreated as a negative control. Samples were subjected to elemental analysis using Energy Dispersive X-ray spectrometer(EDX) where the Calcium and phosphorus contents were estimated and the surface topography was assessed by Scanning-Electron-Microscope(SEM). Comparison of Calcium/Phosphorus ratio was done using One Way ANOVA and the differences in percent change were analyzed using the Kruskal Wallis test. RESULTS: There was a significant difference in the mineral content within each group before and after treatment indicating remineralization in all groups. The percent increase in Ca/P ratio after treatment was higher in P11-4 group with no significant difference between groups. Surface topography showed improvement in all groups with better surface quality in self-assembling peptide P11-4 group than other groups. CONCLUSION: The CPP-ACPF varnish, Self-assembling peptide P11-4 and 5% Sodium fluoride varnish are effective in restoring the mineral content and improving surface morphology of early carious lesions in primary teeth.