Complementary remineralizing effect of self-assembling peptide (P11-4) with CPP-ACPF or fluoride: An in vitro study.

D Kamal,D Elkassas,H Hamza,H Hassanein

doi:10.4317/jced.56295

Abstract

BackgroundSelf-assembling peptide has been recently introduced to promote hard tissue regeneration for treating early non-cavitated carious lesions. This study investigates the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization combined with CPP-ACPF or fluoride. Material and MethodsArtificial enamel lesions were created on buccal surface of 60 specimens and were randomly assigned to six groups according to the remineralizing agent: G1-(Control, artificial saliva), G2-(Fluoride varnish), G3-(CPP-ACPF varnish), G4-(Self-assembling peptide), G5-(Self-assembling peptide+fluoride varnish), G6-(Self-assembling peptide+CPP-ACPF varnish). All products were applied according to manufacturer’s instructions and specimens were stored in a daily renewed artificial saliva. Surface microhardness (SMH) and scanning electron microscope (SEM) were assessed at baseline, after demineralization, 1 week and 4 weeks storage. SMH values were analyzed using ANOVA and Tukey’s post-hoc test. ResultsThe highest statistically significant SMH values were found in G6 followed by G5, G4, G2 and G3 while the lowest values were found in G1. No statistically significant difference was found between G5 and G6. Also, no statistically significant difference was found between G2 and G3. SEM showed that G4, G5, G6 resulted in more pronounced remineralization, reversing the demineralized enamel fish scale pattern compared to G2 and G3 after 1 week and 4 week remineralization. ConclusionsComplementary effect was obtained after combining self-assembling peptide with CPP-ACPF or fluoride showing the highest remineralizing potential early after 1 week and even after 4 weeks compared to when each agent used alone. Added benefits can be obtained through combining self-assembling peptide with other remineralzing agents allowing faster and enhanced regeneration of non-cavitated caries lesions. Key words:Enamel regeneration, biomimetic remineralization, self-assembling peptide, CPP-ACPF, fluoride.

Highlights

The greater understanding of the dental caries process has led to the development of methodologies for detecting early non-cavitated caries lesions and the use of non-invasive methods for treating such lesions
This study was conducted to evaluate the remineralizing potential of the self-assembling peptide combined with casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) or fluoride based systems
The highest surface microhardness (SMH) values were found in self-assembling peptide+casein phosphopeptides (CPP)-ACPF followed by self-assembling peptide+fluoride, self-assembling peptide, fluoride and CPP-ACPF while the lowest values were found in artificial saliva

Summary

Introduction

The greater understanding of the dental caries process has led to the development of methodologies for detecting early non-cavitated caries lesions and the use of non-invasive methods for treating such lesions. In an attempt to clarify the complementary mode of action between different available remineralizing systems; adding the regenerative ability of self-assembling peptide while providing it with a copious source of calcium phosphate or fluoride ions might introduce favorable results. The null hypothesis tested is: there is no difference between the remineralizing potential of the combined self-assembling peptide with CPP-ACPF or fluoride and the remineralzing potential of each agent alone. Following 4 weeks remineralization, the nail varnish was peeled off carefully and the specimens were tested using surface microhardness assessment and scanning electron microscope examination. As for the self-assembling peptide+CPP-ACPF group, no statistically significant difference was found between SMH/baseline and SMH/4 weeks remineralization at p=0.095. For groups G2 and G3, 4 weeks remineralization resulted in better and increased remineralized pattern compared to 1 week remineralization

Findings

Discussion

Conclusions