Self-Assembling Peptide P11-4 as a New Approach in Biomimetic Enamel Remineralization: A Review

Abstract

Dental enamel has poor regeneration capability due to the lack of regenerative cells and vascularization. However, under extreme laboratory circumstances, certain procedures can make enamel-like hydroxyapatite nanorods. Self-assembling peptide P11-4 has been introduced as a biomimetic approach for ‘guided enamel regeneration’. It is a rationally designed peptide, the monomers of which self-assemble into a biocompatible fibrillar scaffold that mimics the enamel matrix in response to particular environmental cues. Information on self-assembling peptide P11-4 was gathered using PubMed. A boolean search of PubMed data was conducted using the keywords: (self-assembling peptide) OR (P11) OR (P11-4 OR P11-4 peptide) AND (self-assembling peptide P11-4) AND (dental caries OR white spot OR incipient caries OR early enamel caries) AND (tooth demineralization OR tooth remineralization OR tooth regeneration). The last search was done on September 2021. Using a similar search method, studies were also obtained from the Cochrane Library and Google Scholar. 10687 articles were retrieved using the search method. More articles were gathered by manually searching the reference lists of articles. In this review, the most relevant papers were picked and used. Available evidence shows that self-assembling peptide P11-4 fibers could bind to calcium ions and template hydroxyapatite formation for the treatment of initial carious lesions, supporting remineralization in the same way that amelogenin stimulates enamel formation.