Abstract
The limitations on the use of fluoride therapy in dental caries prevention has necessitated the development of newer preventive agents. This review focusses on the recent and significant studies on P11-4 peptide with an emphasis on different applications in dental hard tissue conditions. The self-assembling peptide P11-4 diffuses into the subsurface lesion assembles into aggregates throughout the lesion, supporting the nucleation of de novo hydroxyapatite nanocrystals, resulting in increased mineral density. P11-4 treated teeth shows more remarkable changes in the lesion area between the first and second weeks. The biomimetic remineralisation facilitated in conjunction with fluoride application is an effective and non-invasive treatment for early carious lesions. Despite, some studies have reported that the P11-4 group had the least amount of remineralised enamel microhardness and a significantly lower mean calcium/phosphate weight percentage ratio than the others. In addition, when compared to a low-viscosity resin, self-assembling peptides could neither inhibit nor mask the lesions significantly. Moreover, when it is combined with other agents, better results can be achieved, allowing more effective biomimetic remineralisation. Other applications discussed include treatment of dental erosion, tooth whitening and dentinal caries. However, the evidence on its true clinical potential in varied dental diseases still remains under-explored, which calls for future cohort studies on its in vivo efficacy.
Highlights
As early as 1982, Mizrahi stated that demineralisation is evident in early carious lesions known as white spot lesions (WSLs), and the presence of underlying porosities give them a milky appearance [4]
This review describes the technology of self-assembling peptides and the mechanism of 3D scaffold construction, emphasising the notion of de novo hydroxyapatite crystal formation in response to the administration of peptide P11-4, assisting in enamel/dentin remineralisation after the initiation of dental caries
In vivo clinical evaluation of successful treatment by P11-4 peptide is assessed by multiple methods
Summary
Tooth enamel is a complex structure comprising organic and inorganic components that produce the human body’s strongest mineralised structure. In 2021 stated that dental caries results in focal disintegration of the mineralised tissues of teeth which is attributed to numerous cycles of demineralisation and remineralisation, with the intervening phases being either reversible or irreversible [3]. Madan et al [7] in 2011 concluded that the saliva’s buffering effect aids in remineralisation by allowing calcium and phosphate ions to precipitate onto the tooth surface and produce new material. Another group of authors stated the most common early sign of dental caries progression is the appearance of WSLs or reversible regions of demineralisation [8]
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