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Behl M, Taneja S, Bhalla VK. Comparative evaluation of remineralization potential of novel bioactive agents on eroded enamel lesions: A single-blinded in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:545-551. [PMID: 38939544 PMCID: PMC11205173 DOI: 10.4103/jcde.jcde_62_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/29/2024] [Accepted: 04/17/2024] [Indexed: 06/29/2024]
Abstract
Objective The escalating prevalence of noncarious tooth wear stands as a critical concern in the backdrop of evolving lifestyles and dietary patterns. Dental erosion, a progressive condition induced by both endogenous and exogenous acidic influences, directly impacts enamel integrity, resulting in surface loss. The contemporary surge in carbonated beverage consumption further exacerbates this erosive milieu, underscoring the urgency for dental practitioners to adopt meticulous treatment strategies. Existing literature underscores a noteworthy 94% reduction in tooth erosion risk for individuals abstaining from sweetened soft beverages, emphasizing the imperative for a well-devised remineralization protocol to counter demineralized surfaces. Methodology Seventy-three enamel specimens were taken. Forty samples were subjected to pre-operative hardness testing, and five samples were subjected to baseline EDX evaluation followed by grouping of samples (Group 1 = control Group; Group 2 = casein phosphopeptide-amorphous calcium phosphate fluoride [CPP-ACPF] Group; Group 3 = Biomin F Group; and Group 4 = self-assembling peptide [SAP] P-114 Group). A demineralization-remineralization cycle was carried out for 5 days followed by testing through Vickers Microhardness Tester, EDX Evaluation, and Scanning Electron Microscopy (SEM) Imaging. Statistical analysis was performed using one-way analysis of variance followed by intergroup analysis using Tukey's post hoc test with SPSS software 25.0 version. Results The mean percentage change in microhardness values was 30.05% in Group 1, 24.21% in Group 2, 18.85% in Group 3, and 12.08% in Group 4. The mean Ca/P ratio of samples tested through EDAX was 2.20 at baseline, 1.40 in Group 1 (Control Group), 1.62 in Group 2 (CPP-ACPF), 1.82 in Group 3 (Biomin F), and 2.01 in Group 4 (SAP-P114). Postintervention values were statistically significant from baseline values in both parameters. Conclusion Curodont Protect exhibits superior efficacy, offering valuable insights for future in vivo studies and clinical applications. The multifaceted evaluation, encompassing microhardness testing, SEM analysis, and EDXS assessment, contributes to a nuanced interpretation of the agents' impact, paving the way for informed decisions in clinical practice and future research endeavors.
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Affiliation(s)
- Mansi Behl
- Department of Conservative Dentistry and Endodontics, Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Sonali Taneja
- Department of Conservative Dentistry and Endodontics, Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
| | - Vidhi Kiran Bhalla
- Department of Conservative Dentistry and Endodontics, Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India
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Xie Z, Yu L, Li S, Li J, Liu Y. Comparison of therapies of white spot lesions: a systematic review and network meta-analysis. BMC Oral Health 2023; 23:346. [PMID: 37264364 DOI: 10.1186/s12903-023-03076-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE White spot lesions (WSLs), the earliest evidence of enamel demineralization, are considered amenable to intervention to achieve a remineralized or arrested state of caries. The management of WSLs is quite challenging, and there is no definitive cure as yet. We performed a network meta-analysis to assess the efficacy of seven therapies for WSLs and gave a hierarchy of them. MATERIALS AND METHODS We systematically searched the PubMed, EMBASE, Cochrane, and Web of Science databases (last search: July 2022) to identify all relevant studies. We limited our search to studies published in English. Randomized controlled designed in vitro/clinical trials related to the efficacy of the seven therapies for WSLs were included. Data extraction was performed independently by two reviewers. The risk of bias (ROB) 2.0 tool from Cochrane and a previous in vitro methodological tool will be used for the quality assessment. Variations in quantitative light-induced fluorescence (QLF), laser fluorescence (LF), and lesions area were the primary outcome measures. Standard mean difference (SMD) was used as the effect size for the Network meta-analysis (NMA). Consistency and inconsistency tests were conducted. The hierarchy of 7 treatment effects was evaluated using surface probabilities under cumulative ranking (SUCRA). Publication bias was evaluated using a bias plot. RESULTS Forty-two articles were included in the systematic review. Thirty-one of them, with a total of 1906 participants, were included in the network meta-analysis. The studies owned a low and moderate risk of bias. This analysis does not suffer from significant inconsistency. The difference between 4 groups 'self-assembled peptide (SAP) P11-4', 'P11-4 + Fluoride Varnish (FV)', 'Resin Infiltration (RI)', 'casein phosphor peptides-amorphous calcium fluoride phosphate (CPP-ACFP)' and the 'Control' group was found to be statistically significant. Compared to the 'FV' and 'casein phosphor peptides-amorphous calcium phosphate (CPP-ACP)' groups, the 'P11-4 + FV" group and 'RI" group made a significant difference. The hierarchy was evident in the SUCRA values of 7 therapies. P11-4 + FV and RI were considered effective therapies compared to the control group or the FV group (gold standard group). CONCLUSIONS The available evidence suggests that resin infiltration and P11-4 in combination with fluoride varnish had advantages over gold standard (FV). The effect of tricalcium phosphate-based drugs and fluoride is not very noticeable. Overall, drugs based on P11-4 and resin infiltration will be better therapies. Using more than two drugs in combination also would increase efficacy.
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Affiliation(s)
- Zunxuan Xie
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Lei Yu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Sining Li
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Jianing Li
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Yuyan Liu
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China.
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Ghaly YS, El-Wassefy NA, Shamaa MS, Tawfik MA. Effect of self-assembling peptide and other remineralizing agents on preventing initial enamel lesions around orthodontic brackets: An in vitro comparative study. Int Orthod 2023; 21:100751. [PMID: 37003059 DOI: 10.1016/j.ortho.2023.100751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To investigate and compare the effect of self-assembling peptide SAP (P11-4), casein phosphopeptide-amorphous calcium phosphate fluoride paste (CPP-ACPF), and fluoride varnish (FV) on preventing enamel demineralization around orthodontic brackets. MATERIAL AND METHODS Orthodontic brackets were bonded to the buccal surfaces of 80 freshly extracted human maxillary premolars. Teeth were randomly assigned to four groups (n=20) according to the remineralizing agent used as follows: SAP (P11-4) group (Curodont™ Protect/Credentis), CPP-ACPF group (MI Paste Plus®/Recaldent™), fluoride varnish group (Profluoride varnish®/VOCO), and control group. All products were applied according to the manufacturer's instructions. Specimens were cycled in daily refreshed demineralizing and remineralizing solutions for 8h and 16h, respectively, for 28 days. The calcium/phosphorus ratio (Ca/P) and surface microhardness (SMH) were evaluated at baseline and at two and four weeks. Two-way ANOVA (analysis of variance), one-way ANOVA and repeated measures ANOVA were used for statistical analysis. RESULTS Two-way ANOVA demonstrated significant differences between remineralizing agents and time points. After 4 weeks, the SAP (P11-4) group had had significantly higher Ca/P ratio and SMH (1.68±0.11 and 346.47±55.38) compared to other groups, followed by CPP-ACPF (1.52±0.19 and 283.53±64.75), FV (1.37±0.14 and 262.80±82.98), and the control group (1.31±0.10 and 213.00±41.95). Significantly higher Ca/P ratio and SMH were observed at 2 weeks in the control group (1.44±0.10 and 269.63±57.37) and FV group (1.52±0.09 and 321.17±55.24) compared to 4 weeks. No significant differences were found regarding Ca/P ratio and SMH at 2 weeks in the CPP-ACPF (1.55±0.15 and 295.14±53.88) and SAP P11-4 groups (1.64±0.10 and 320.18±58.04) compared to 4 weeks. CONCLUSION SAP (P11-4) had the greatest remineralizing efficacy compared to FV and CPP-ACPF. Moreover, extended period of time improved the preventive efficacy of SAP (P11-4) compared to the other regimens.
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Affiliation(s)
- Yasmin Samir Ghaly
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt.
| | - Noha A El-Wassefy
- Department of Dental Biomaterials, Mansoura University, Faculty of Dentistry, Mansoura, Egypt
| | - Marwa Sameh Shamaa
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt
| | - Marwa Ali Tawfik
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt
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Hardan L, Chedid JCA, Bourgi R, Cuevas-Suárez CE, Lukomska-Szymanska M, Tosco V, Monjarás-Ávila AJ, Jabra M, Salloum-Yared F, Kharouf N, Mancino D, Haikel Y. Peptides in Dentistry: A Scoping Review. Bioengineering (Basel) 2023; 10:bioengineering10020214. [PMID: 36829708 PMCID: PMC9952573 DOI: 10.3390/bioengineering10020214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Currently, it remains unclear which specific peptides could be appropriate for applications in different fields of dentistry. The aim of this scoping review was to scan the contemporary scientific papers related to the types, uses and applications of peptides in dentistry at the moment. Literature database searches were performed in the following databases: PubMed/MEDLINE, Scopus, Web of Science, Embase, and Scielo. A total of 133 articles involving the use of peptides in dentistry-related applications were included. The studies involved experimental designs in animals, microorganisms, or cells; clinical trials were also identified within this review. Most of the applications of peptides included caries management, implant osseointegration, guided tissue regeneration, vital pulp therapy, antimicrobial activity, enamel remineralization, periodontal therapy, the surface modification of tooth implants, and the modification of other restorative materials such as dental adhesives and denture base resins. The in vitro and in vivo studies included in this review suggested that peptides may have beneficial effects for treating early carious lesions, promoting cell adhesion, enhancing the adhesion strength of dental implants, and in tissue engineering as healthy promotors of the periodontium and antimicrobial agents. The lack of clinical trials should be highlighted, leaving a wide space available for the investigation of peptides in dentistry.
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Affiliation(s)
- Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Jean Claude Abou Chedid
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Rim Bourgi
- Department of Restorative Dentistry, School of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
| | - Carlos Enrique Cuevas-Suárez
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca 42160, Mexico
- Correspondence: (C.E.C.-S.); (N.K.); (Y.H.); Tel.: +52-(771)-72000 (C.E.C.-S.)
| | | | - Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy
| | - Ana Josefina Monjarás-Ávila
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca 42160, Mexico
| | - Massa Jabra
- Faculty of Medicine, Damascus University, Damascus 0100, Syria
| | | | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000 Strasbourg, France
- Correspondence: (C.E.C.-S.); (N.K.); (Y.H.); Tel.: +52-(771)-72000 (C.E.C.-S.)
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
- Correspondence: (C.E.C.-S.); (N.K.); (Y.H.); Tel.: +52-(771)-72000 (C.E.C.-S.)
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Rangappa KG, Garain R, Ahmad ZH, Jain K, Arroju R, Boregowda V. Remineralization Potential of a Combination of Chitosan with Nanohydroxyapatite and a Self-assembling Peptide with Nanohydroxyapatite: An In Vitro Study. J Contemp Dent Pract 2022; 23:1255-1259. [PMID: 37125524 DOI: 10.5005/jp-journals-10024-3434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
AIM This study explores the demineralizing potential of the combination of chitosan with nanohydroxyapatite (n-HA) and self-assembling peptides with n-HA. MATERIALS AND METHODS A total of 66 first premolar teeth of similar dimensions extracted for orthodontic purposes were collected for this study. These were then demineralized and randomly divided into the following three groups (n = 22): (i) Control group, (ii) n-HA + Chitosan (HAC), and (iii) self-assembling peptide + n-HA (SP-HA). The samples in each group were brushed every 24 hours with the respective agent. The specimens were stored in Fusayama Meyer's artificial saliva at room temperature and the solution was replenished daily. Mineral content (Ca, P) and surface morphology of the specimens was analyzed, using scanning electron microscopy and energy dispersion X-ray spectroscopy (SEM-EDAX), before demineralization, at 15 days of remineralization and 30 days of remineralization. A two-way analysis of variance (ANOVA) test followed by Tukey's honest significant difference (HSD) post hoc analysis was used to compare the mean elemental composition of the different groups (p < 0.05). RESULTS There was no significant difference in the calcium (Ca) and phosphate (P) weight percentage between the different groups at the baseline and after demineralization. The Ca and P weight percentages of all three groups after remineralization for 15 and 30 days showed no significant difference from the baseline or after demineralization. The surface morphology after 15 days of remineralization therapy showed decreased surface porosity and increased mineral deposition in the HAC group than the HP-SA group. Surface morphology after 30 days of remineralization showed a more homogenous and smoother surface in the HAC group than the HP-SA group. CONCLUSION From the results of this study, it can be concluded that the combination of chitosan with n-HA and self-assembling peptides with n-HA can be considered effective demineralizing agents. CLINICAL SIGNIFICANCE Considering the non-invasive nature of remineralization therapy understanding the effectiveness of different agents is of utmost importance. The demineralizing properties of chitosan, n-HA and self-assembling peptides make their combinations ideal for studying their effectiveness in treating white spot lesions.
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Affiliation(s)
- Krishnakumar Gollahalli Rangappa
- Department of Conservative Dentistry and Endodontics, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India, Phone: +91 8553036155, e-mail:
| | - Ridyumna Garain
- Department of Conservative Dentistry and Endodontics, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India
| | - Zeeshan Heera Ahmad
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Medical City, Riyadh, Saudi Arabia
| | - Komal Jain
- Department of Conservative Dentistry and Endodontics, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India
| | - Ramakrishna Arroju
- Dental Centre, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa, Saudi Arabia
| | - Vedavathi Boregowda
- Department of Conservative Dentistry and Endodontics, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India
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Üstün N, Güven Y. Effect of three different remineralizing agents on artificial erosive lesions of primary teeth. Aust Dent J 2022; 67:271-280. [PMID: 35694835 DOI: 10.1111/adj.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to investigate the efficacy of three remineralizing agents on dental erosion in primary teeth. METHODS Forty primary molars were randomly divided into four groups (n = 10 each): self-assembling peptide (P11-4 ), casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP), sodium fluoride (NaF) and artificial saliva (AS; control). The erosion-like formation was created by immersing the samples in citric acid (4 × 2 min, pH 2.3) and AS (4 × 2 h, pH 7). The eroded samples were then treated with remineralizing agents and subjected to further erosion consisting of 15 cycles (3x/8-h interval) of immersion in citric acid and AS for 6 s each. Alterations in the mineral content and morphology of the samples were quantified using a microhardness tester and atomic force microscope. RESULTS All agents had a significant remineralization effect on eroded primary tooth enamel. After further erosive challenge, enamel loss in the CPP-ACFP group was found to be significantly lower than in all other groups, and no significant difference was found between the P11-4 and NaF groups. CONCLUSIONS This study showed that all tested materials had remineralization ability, and CPP-ACFP had a superior effect in inhibiting enamel loss due to dental erosion in primary teeth. © 2022 Australian Dental Association.
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Affiliation(s)
- N Üstün
- Faculty of Dentistry, Department of Pedodontics, Istanbul Medipol University, Istanbul, Turkey
| | - Y Güven
- Faculty of Dentistry, Department of Pedodontics, Istanbul University, Istanbul, Turkey
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B K A, R Y, Puranik MP. Remineralizsation of early enamel caries lesions using self-assembling peptides P11-4: Systematic review and meta-analysis. J Oral Biol Craniofac Res 2022; 12:324-331. [DOI: 10.1016/j.jobcr.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/19/2022] [Indexed: 10/18/2022] Open
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Hemalatha P, Padmanabhan P, Muthalagu M, Hameed MS, Rajkumar DI, Saranya M. Comparative evaluation of qualitative and quantitative remineralization potential of four different remineralizing agents in enamel using energy-dispersive X-ray: An in vitro study. J Conserv Dent 2021; 23:604-608. [PMID: 34083917 PMCID: PMC8095692 DOI: 10.4103/jcd.jcd_541_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/10/2020] [Accepted: 12/29/2020] [Indexed: 11/04/2022] Open
Abstract
Background: The principles of minimally invasive dentistry clearly tells us the need for clinically effective measures to remineralize the early enamel caries lesions. Aims and Objectives: The aim of this study was to evaluate the remineralisation potential of four different remineralisation agents used quantitatively by surface microhardness and qualitatively by energy dispersive X ray analysis. Materials and Methods: Artificial enamel lesions were created on the buccal surfaces of 60 extracted mandibular second premolar. Specimens were randomly assigned to four groups (n=15) according to the remineralisation agents used: Group 1-Nano Hydroxyapatite, Group 2-Fluoride, Group 3-CPP ACP, Group 4-Chitosan 5mg. All products were applied according to the manufacturer's instructions and specimens were stored in daily renewed artificial saliva. Surface microhardness was assessed using Rockwell hardness test and change in mineral content was evaluated using Energy Dispersive X ray analysis. Statistical Analysis: One way analysis of Variance test and post-hoc Tukey test were conducted for multiple group comparison. Results: There was remarkable remineralisation in Hydroxyapatite treated comparatively to the other three groups. Conclusion: All remineralising agents showed improved surface remineralisation. However complete remineralisation did not occur within 7 days. Nanohydroxyapatite showed the highest potential for remineralisation followed by CPP-ACP, Chitosan and Fluoride.
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Affiliation(s)
- P Hemalatha
- Department of Conservative Dentistry and Endodontics. Ultra's Best Dental Science College, Madurai, Tamil Nadu, India
| | - Prabeesh Padmanabhan
- Department of Conservative Dentistry and Endodontics. Ultra's Best Dental Science College, Madurai, Tamil Nadu, India
| | - M Muthalagu
- Department of Conservative Dentistry and Endodontics. Ultra's Best Dental Science College, Madurai, Tamil Nadu, India
| | - Mahaboob Shahul Hameed
- Department of Conservative Dentistry and Endodontics. Ultra's Best Dental Science College, Madurai, Tamil Nadu, India
| | - D Immanuel Rajkumar
- Department of Conservative Dentistry and Endodontics. Ultra's Best Dental Science College, Madurai, Tamil Nadu, India
| | - M Saranya
- Department of Conservative Dentistry and Endodontics. Ultra's Best Dental Science College, Madurai, Tamil Nadu, India
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Sedlakova Kondelova P, Mannaa A, Bommer C, Abdelaziz M, Daeniker L, di Bella E, Krejci I. Efficacy of P 11-4 for the treatment of initial buccal caries: a randomized clinical trial. Sci Rep 2020; 10:20211. [PMID: 33214593 PMCID: PMC7678830 DOI: 10.1038/s41598-020-77057-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/09/2020] [Indexed: 11/09/2022] Open
Abstract
To investigate the safety and efficacy of Self-Assembling Peptide P11-4 (SAP P11-4) compared to placebo or fluoride varnish (FV), a randomized, controlled, blinded, split-mouth study with sequential design was conducted. Subjects presenting two teeth with White-Spot-Lesions (WSLs) were included and teeth were randomly assigned to test or control. Control received placebo at baseline (D0) and test SAP P11-4, all received FV at Day 90 (D90). Standardized photographs were taken at each visit, and WSL size changes were morphometrically assessed. Hierarchical Linear Modelling, considering paired and sequential design, was used to test four hypotheses. SAP P11-4 lesions (test, D90–D0) showed significant WSL size reduction compared to placebo (control, D90–D0; p = 0.008) or FV (control, D180–D90; p = 0.001). Combination of SAP P11-4 and delayed FV after 90 days (test, D180–D0), showed a significant difference compared to FV alone (control D270–D90; p = 0.003). No significant difference on FV efficacy was found when SAP P11-4 was applied 3 months before FV (test D270–D90; control D270–D90, p = 0.70). SAP P11-4 treatment resulted in superior caries regression compared to either placebo or FV, and FV efficacy seems not to be affected by SAP P11-4. SAP P11-4 was found to be a safe and effective WSL treatment.
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Affiliation(s)
| | - Alaa Mannaa
- Division of Operative Dentistry, Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589, Kingdom of Saudi Arabia
| | | | - Marwa Abdelaziz
- University of Geneva, University Dental Clinics CUMD, rue Michel-Servet 1, 1211, Geneva 4, Switzerland
| | - Laurent Daeniker
- University of Geneva, University Dental Clinics CUMD, rue Michel-Servet 1, 1211, Geneva 4, Switzerland
| | - Enrico di Bella
- Department of Political Sciences, University of Genova, P.le E. Brignole 3a, 16126, Genova, Italy
| | - Ivo Krejci
- University of Geneva, University Dental Clinics CUMD, rue Michel-Servet 1, 1211, Geneva 4, Switzerland.
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Welk A, Ratzmann A, Reich M, Krey KF, Schwahn C. Effect of self-assembling peptide P 11-4 on orthodontic treatment-induced carious lesions. Sci Rep 2020; 10:6819. [PMID: 32321955 PMCID: PMC7176635 DOI: 10.1038/s41598-020-63633-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 03/31/2020] [Indexed: 02/07/2023] Open
Abstract
This study aimed to evaluate the effect of self-assembling peptide P11-4 (SAP) in the therapy of initial smooth surface caries (white spot lesions, WSL) following orthodontic multibracket treatment. Twenty-three patients (13f/10m; average age 15.4 years) with at least two teeth with WSL were recruited for the randomised controlled clinical trial with split-mouth design. In opposite to the control teeth, the test teeth were treated with SAP on Day 0. The primary endpoint was the impedance measurement of WSL using customised tray to ensure reproducibility of the measurement location. The secondary endpoint was the morphometric measurement of WSL using a semi-automated approach to determine the WSL size in mm2. Treatment effects were adjusted for site-specific baseline values using mixed models adapted from the cross-over design. Test WSL showed a mean baseline impedance value of 46.7, which decreased to 21.1, 18.4, and 19.7 after 45, 90, and 180 days, respectively. Control WSL showed a mean baseline value of 42.0, which decreased to 35.0, 29.5, and 33.7, respectively. The overall treatment contrast was -13.7 (95% CI: -19.6 - -7.7; p < 0.001). For the secondary endpoint, the test WSL size decreased from 8.8 at baseline to 6.5 after 180 days. The control WSL decreased from 6.8 to 5.7, respectively. The related treatment contrast was -1.0 in favour of test WSL (95% CI: -1.6 - -0.5; p = 0.004). The treatment of initial carious lesions with self-assembling peptide P11-4 leads to superior remineralisation of the subsurface lesions compared with the control teeth.
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Affiliation(s)
- A Welk
- Dental school of the University Medicine Greifswald, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, Greifswald, Germany.
| | - A Ratzmann
- Dental school of the University Medicine Greifswald, Department of Orthodontics, Greifswald, Germany
| | - M Reich
- Dental school of the University Medicine Greifswald, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, Greifswald, Germany
| | - K F Krey
- Dental school of the University Medicine Greifswald, Department of Orthodontics, Greifswald, Germany
| | - Ch Schwahn
- Dental school of the University Medicine Greifswald, Department of Prosthodontics, Greifswald, Germany
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