Curodont Repair Research Articles

Evaluation of the remineralization potential of self-assembling peptide P11-4 with fluoride compared to fluoride varnish in the management of incipient carious lesions: a randomized controlled clinical trial

ObjectivesThe present trial’s aim was to compare the remineralization potential of self-assembling peptide P11-4 combined with fluoride to that of fluoride varnish.Materials and methodsTwenty-eight participants with 58 incipient carious lesions were enrolled in the present trial. Participants were randomly divided into two groups with 14 participants and 29 incipient lesions in each group. Patients were assigned either to self-assembling peptide combined with fluoride (Curodont Repair Fluoride Plus™) or sodium fluoride varnish (NaF, Bifluorid 10) groups. Both agents were applied according to the manufacturer’s instructions on non-cavitated incipient carious lesions. Lesions were assessed by two calibrated and blinded assessors at baseline, and after one-, three- and six-months using a laser fluorescence device (DIAGNOdent).ResultsAlthough laser fluorescence scores significantly improved in both groups over time (p < 0.05), no notable differences were evident between both groups at one-month (p > 0.05). Yet, at three- and six-months statistically lower laser fluorescence readings were evident in the self-assembling peptide combined with fluoride group in comparison to the fluoride alone group (p < 0.05). There was 60% less risk for caries progression for Curodont Repair Fluoride Plus™ when compared to NaF varnish after six months. Self-assembling peptide combined with fluoride was able to change 65.5% of non-cavitated carious lesions from DIAGNOdent score 3 (11–20) to score 1 (0–4). Fluoride varnish was able to change 13.8% of the lesions from score 3 to score 1 after six months.ConclusionsThe self-assembling peptide combined with fluoride varnish showed higher remineralization potential than fluoride varnish alone for incipient carious lesions over a six-months follow up.Clinical relevanceThe combination of self-assembling peptide P11-4 and fluoride could offer a new tool in managing incipient carious lesions.

A Comparison of the Enamel Remineralisation Potential of Self-Assembling Peptides

The aim of this research was to compare the efficacy of the remineralising potential of self-assembling peptides (SAPs): Curodont Repair (P11-4), P26, and leucine-rich amelogenin peptides (LRAP) with the standard 5% NaF varnish (Duraphat) on early enamel caries lesions (EECLs). A demineralising solution (DS) was used to create artificial EECLs in human dental enamel specimens, which were randomly allocated to treatment groups: P11-4; P26 solution; LRAP solution; 5% NaF varnish; and deionised water (DIW). Each specimen was subjected to 8 days of pH cycling. Specimens from each test group were subjected to microcomputed tomography (micro-CT) and nanomechanical testing to assess mineral density (MD), hardness (H), and elastic modulus (EM) properties of sound, demineralised, and treated enamel. The mean MD percentage gain was highest in the P26 and P11-4 groups, followed by the LRAP, 5% NaF varnish, and DIW groups. There were statistically significant differences amongst groups. In the outer layer of EECLs, the EM and H were highest in P26 and P11-4 groups, followed by the LRAP and 5% NaF varnish. In the inner layer of EECLs, the EM and H were highest in P11-4 and P26 groups, indicative of enhanced penetration and remineralisation of the deeper parts of the artificial EECLs. P26 and P11-4 SAPs are more effective than 5% NaF varnish in remineralising the depth of EECLs.

Surface Accumulation of Cerium, Self-Assembling Peptide, and Fluoride on Sound Bovine Enamel.

The accumulation of caries-preventive compounds on sound enamel is crucial in order to improve the inhibition of carious lesion initiation. The aim of this research was to investigate the initial accumulation of cerium, oligopeptide p11-4, and fluoride from NaF or amine fluoride (AmF) on sound enamel in vitro by means of energy dispersive X-ray spectroscopy (EDX). Polished bovine enamel specimens (n = 120 from 60 teeth) were fabricated. Out of these, 12 specimens each were treated with CeCl3 (cerium(III) chloride heptahydrate 25%), oligopeptide p11-4 (Curodont Repair, Credentis), NaF (10,000 ppm F-), AmF (amine fluoride, Elmex Fluid, CP-GABA GmbH, 10,000 ppm F-), or Aqua demin (control). After rinsing with water, the surface elemental composition (Ce, N, F, Ca, P, O, Na, Mg) was measured (EDX; EDAX Octane Elect detector, APEX v2.0), expressed in atomic percent (At%) and analyzed (non-parametric statistics, α = 0.05, error rates method). Another 12 specimens per treatment group were fabricated and used for analyzing accumulation in cross-sections with EDX linescans and two-dimensional EDX-mappings. The surface median atomic percent of cerium (At%Ce) was 0.8 for CeCl3, but no Ce was found for any other group. N, specifically for oligopeptide p11-4, could not be detected. Fluorine could only be detected on fluoridated surfaces. The median atomic percent of fluorine (At%F) was 15.2 for NaF and 17.0 for AmF. The Ca/P ratio increased significantly compared to the control following the application of NaF and AmF (p &lt; 0.001), but decreased significantly for CeCl3 (p &lt; 0.001). In cross-sectioned specimens of the CeCl3-group, 12.5% of the linescans revealed cerium at the enamel surface, whereas 83.3% of the NaF linescans and 95.8% of the AmF linescans revealed fluorine at the enamel surface. Following the application of oligopeptide p11-4, no traces of N were detectable. In the depth of the samples, no signal was detected for any of the corresponding elements exceeding the background noise. Cerium and fluorine (from both NaF and AmF), but not the oligopeptide p11-4, precipitated on sound enamel.

Remineralization potential of P11-4 and fluoride on secondary carious primary enamel: A quantitative evaluation using microcomputed tomography.

The aim of this study was to assess the ability of self-assembling peptide (P11-4) diffusion, assembly, and remineralization to effect artificial secondary caries-like lesions in human primary teeth in vitro. Enamel-dentin blocks obtained from extracted human primary molars were embedded into epoxy resin blocks. Cavities (approximately 1 × 1 × 2 mm) were prepared on the surface using a high-speed diamond bur under constant water cooling and filled with composite restorative material (Filtek Z250; 3M ESPE). The samples were immersed in demineralizing solution (20 ml) for 96 h to produce secondary caries lesions and divided into two groups according to the testing materials: fluoride varnish (Duraphat; Colgate, UK) and P11-4 (Curodont Repair; Credentis, Switzerland). Except for the control areas, all samples were remineralized for 3-5min using the remineralizing agents, and then all the sections were placed in a pH-cycling system for 5 days at 35°C. The pH cycling procedure was followed by micro-CT analysis for the qualitative evaluation of surface changes. The Mann-Whitney U test was used to compare two independent groups. In the comparison of more than two dependent groups, Bonferroni smoothed pairwise analyses were used to determine the source of the Kruskal-Wallis H test difference. The results of the study revealed that the remineralization depths of the peptide group were higher than those of the fluoride group (p < .01). There was a statistically significant difference in remineralization effects between the fluoride and peptide groups. P11-4 can be considered as an effective remineralizing agent for secondary caries lesions.

Evaluation of the state and shade of white spot lesions after treatment with different remineralizing agents ( An in-vivo comparative study ).

Objective: This study was performed to evaluate the effect of three remineralizing agents’ (Curodont repair, Clinpro XT varnish, and Clinpro white varnish) application on the state and shade of white spot. Materials and methods: Twenty patients were included in this study. The state and shade of white spot lesions before the application of the remineralizing agents were assessed using two devices, which are the Diagnodent Pen and Vita easyshade V. The affected nearest right tooth to the midline was treated with Curodont™ Repair, while the affected nearest left tooth to the midline was treated using Clinpro™ XT Varnish, and the third right or left affected tooth was treated using Clinpro white varnish (3M ESPE Dental). After the application, each white spot lesion of the treated tooth was evaluated immediately, after three months and after six months. Results: Both Curodont™ Repair and Clinpro™ XT Varnish showed significant improvement in the state (p < 0.001) and shade (p < 0.001) of the lesions after application, both immediately and after three and six months, with no significant difference between the effect of both treatments (p=0.140 and p=0.985 respectively). Clinpro white varnish showed no significant improvement in the state and shade after application, immediately or after three and six months. Conclusion: Curodont™ Repair and Clinpro™ XT Varnish showed significant improvement in the progression white spot lesions. Clinpro white varnish showed no significant effect.

Comparative Assessment of remineralizing potential of recent biomimetic remineralizing agents on sub-surface carious lesions: An in vitro study

Introduction: Enamel demineralization and remineralization are considered dynamic and continuous process that occurs throughout the life. Subsurface caries is distinct when the amount of subsurface minerals missed go above the amount of minerals secured. The biomimetic remineralizing protocol is planned to encourage maximum maintenance of healthy dental hard tissues in subsurface stage. Aim: Directed to assess the remineralizing potential of self-assembling peptide P11-4, phosphorylated chitosan and nano hydroxyapatite paste on subsurface carious lesions. Materials and methods: Forty sound non-carious human anterior teeth were used. The teeth were divided into four groups (10 teeth each). Group A1: control; Group A2: using Curodont repair; Group A3 using phosphorylated chitosan and; Group A4: using nanohydroxyapatite paste. All products were applied according to the manufacturer's instructions and each group was subdivided into two groups according to the storage time group B1: 3 months and group B2: 6 months. Calcium and phosphorous weight and ratio were assessed using dispersive X-ray energy and Diagnodent pen at base line then after 3and 6months. The mean and standard deviation values were calculated for each group in each test. Results: Specimens treated with Curodont repair after six months record the highest mean value while the lowest mean value was found in artificial saliva, also for all remineralizing agents (Curodont repair, phosphorylated chitosan, and Nanohydroxyapatite paste) and control group the remineralization potential was increased by increasing the storage time (three month and six months). Conclusion: Curodont repair is considered a valuable biomimetic remineralizing agent. Keywords: Remineralization, Chitosan, self-assemblingpeptideP11-4, Nanohydroxyapatite paste.

Comparative evaluation of fluoride varnishes, self-assembling peptide-based remineralization agent, and enamel matrix protein derivative on artificial enamel remineralization in vitro

BackgroundOne of the most unfavorable side effects of fixed orthodontic treatment is white spot lesions (WSLs). Although the most important approach is prevention of WSLs, it is also essential to evaluate the efficacy of the remineralization agents. However, there is no concurrence in the literature with respect to the remineralization process of these agents. The objective of the present study was to evaluate the effects of different fluoride varnishes, enamel matrix protein, and self-assembling peptide derivatives with varying chemical compositions on remineralization of artificially created WSLs in vitro using quantitative light-induced fluorescence (QLF).MethodsArtificial WSLs were created on bovine enamel samples using acidic buffer solution (pH 5, 10 days). Specimens were randomly allocated to six groups (n = 10/group): (1) Emdogain (Straumann, Basel, Switzerland), (2) Curodont Repair (Credentis AG, Switzerland), (3) Duraphat (Colgate-Palmolive, New York, NY), (4) Clinpro XT (3 M ESPE, Pymble, New South Wales, Australia), (5) Enamel Pro Varnish (Premier Dental Products, PA, USA), and (6) control (untreated). The agents were applied to the WSLs according to the manufacturers’ instructions. Fluorescence loss (ΔF), lesion area (area), and impact (ΔQ) values of enamel surfaces were quantified by QLF-D BiluminatorTM (Inspektor-Pro, Amsterdam, The Netherlands) at baseline and after 7, 14, and 21 days of application of the respective materials.ResultsΔF value presented a significantly decreasing trend throughout the 21 days for all groups except the Duraphat and Enamel Pro varnishes. The changes between 14th and 21st days of the Clinpro XT varnish application were significantly higher than Emdogain, Curodont, and Enamel Pro. The Curodont group showed higher lesion area changes between the first and second week in comparison to the Emdogain, Clinpro XT, and Enamel Pro groups, whereas Clinpro XT assured the highest reduction from the second to the third week of the observation period.ConclusionsThe fluorescence loss was significantly reduced with enamel matrix protein, self-assembling peptide, and light-curable fluoride varnishes in the analysis for 21 days. Curodont and Clinpro XT were effective in diminishing the fluorescence loss and lesion area compared to the Duraphat, Enamel Pro fluoride varnishes, and Emdogain in different time points.

Adhesion and whitening effects of P11-4 self-assembling peptide and HAP suspension on bovine enamel

ObjectivesThis study evaluated the adhesion and whitening effects of a combination of P11-4 self-assembling peptide and hydroxyapatite (peptide-HAP) on bovine enamel.MethodsForty-six caries-free bovine teeth were selected, and 40 teeth were randomly allocated to one of five groups (n = 8). First, the effects of application frequency, exposure time, and storage in saliva on the whitening effects of an experimental low-concentrated peptide-HAP suspension (0.5 wt% HAP; Curodont, Credentis) were evaluated and compared with a commercial bleaching agent (VivaStyle Paint on Plus, VS, Ivoclar Vivadent). Tooth color was measured using a spectrophotometer (Gretag MacBeth), and color changes ΔE were statistically analyzed. Second, the effects of peptide-HAP concentration (low versus high: 6.25% HAP; Curodont Protect), and its interactions with saliva and postapplication restaining, were investigated. Third, enamel surfaces (n = 2) were treated with low concentration peptide-HAP and high-concentration peptide-HAP in polymeric and monomeric forms (Curodont Protect & Curodont Repair, Credentis) and analyzed by SEM.ResultsThe ΔE of the low-concentration peptide-HAP suspension did not differ from that of VS. Application frequency, exposure time, and storage in saliva did not have any significant impact on whitening efficacy of the peptide-HAP suspension. Increasing the concentration of the suspension did not promote overall ΔE. SEM observations confirmed the presence of the newly generated peptide and HAP on the enamel surface.ConclusionsThe peptide-HAP suspension is a mild tooth whitener, and the adhesion of peptide-HAP to enamel is concentration dependent.Clinical relevanceThis peptide-HAP suspension is effective in offsetting discoloration caused by restaining after treatment.

Effect of the caries-protective self-assembling peptide P11-4 on shear bond strength of metal brackets.

PurposeDuring orthodontic treatment with fixed appliances, demineralization around brackets often occurs. The aim of this in vitro study was to investigate the effect of the caries-protective self-assembling peptide P11‑4 (SAP P11-4) on the shear bond strength of metal brackets.MethodsIn all, 45 extracted human wisdom teeth were available for the study. The teeth were randomly divided into 3 groups (each n = 15) and pretreated as follows: test group 1: application of SAP P11‑4 (Curodont Repair, Windisch, Switzerland) and storage for 24 h in artificial saliva; test group 2: application of SAP P11‑4; control group: no pretreatment with SAP P11‑4. A conventional metal maxillary incisor bracket (Discovery, Dentaurum, Ispringen) was adhesively bonded to each buccal surface. The shear bond strength was tested according to DIN 13990. After shearing, the Adhesive Remnant Index (ARI) was determined microscopically (10 × magnification). Analysis of variance (ANOVA) was used to check the groups for significant differences (α = 0.05). The distribution of the ARI scores was determined with the χ 2 test.ResultsThere was no significant difference in shear forces between the groups (p = 0.121): test group 1 = 17.0 ± 4.51 MPa, test group 2 = 14.01 ± 2.51 MPa, control group 15.54 ± 4.34 MPa. The distribution of the ARI scores between the groups did not vary (p-values = 0.052–0.819).ConclusionThe application of the caries protective SAP P11‑4 before bonding of brackets did not affect the shear bond strength. Therefore, pretreatment of the enamel surface with SAP P11‑4 shortly before bracket insertion can be considered.

Remineralization Potential of Curodont Repair Flouride Plus Versus CPP-ACP in Management of White Spot Lesions: Randomized Clinical Trial

Remineralization Potential of Curodont Repair Flouride Plus Versus CPP-ACP in Management of White Spot Lesions: Randomized Clinical Trial

Effectiveness of Self-assembling Peptide P11-4 Compared to Tricalcium Phosphate Fluoride Varnish in Remineralization of White Spot Lesions: A Clinical Randomized Trial.

BackgroundFluoride varnish with therapeutic tricalcium phosphate formulas such as Clinpro™ varnish has shown greater tendency in treating white spot lesions (WSLs) by inhibiting the progression of initial enamel lesions through the mineral exchange. The self-assembling peptide SAP11-4 (Curodont Repair, CDR) works on a different scale in treating WSLs by mimicking the enamel matrix and aiming to guided enamel regeneration.AimTo quantitatively and qualitatively compare the effectiveness of the SAP11-4 vs tricalcium posphate fluoride (TCPF) in remineralization of WSLs in young permanent teeth.Materials and methodsNine healthy patients were enrolled in this study. The trial was performed on 40 young permanent teeth in the initial demineralization stage. Teeth were randomly assigned to receive either TCPF (group I) or SAP11-4 (group II). Lesions were assessed at pretreatment, 3, and 6 months posttreatment quantitatively per laser fluorescence DIAGNOdent pen and qualitatively through the International Caries Detection and Assessment System (ICDAS) II.ResultsThe result of the current study revealed a significant quantitative and qualitative increase in remineralization of WSLs in both groups and over time intervals. However, the WSL recovery was significantly better in the self-assembling peptide group, reflecting an excellent remineralization potential of the WSLs by the SAP11-4 compared to TCPF varnish.ConclusionBoth TCPF and SAP11-4 were effective in treating WSLs. However, the success of guided enamel regeneration by the SAP11-4 through the biomineralization has proven superiority of this material compared to TCPF.Clinical significanceEarly detection of WSLs and minimal intervention through remineralizing agents can limit unnecessary tissue loss, further caries progression, and consequently prevent further harm to the patients.How to cite this articleKobeissi R, Badr SBY, Osman E. Effectiveness of Self-assembling Peptide P11-4 Compared to Tricalcium Phosphate Fluoride Varnish in remineralization of White Spot Lesions: A Clinical Randomized Trial. Int J Clin Pediatr Dent 2020;13(5):451–456.

Analysis of efficacy of the self-assembling peptide-based remineralization agent on artificial enamel lesions.

The objective of this in vitro study was to analyze and compare the biomimetic remineralizing efficacy of the self-assembling peptide (P11-4) with agents containing casein phoshopeptide-amorhous calcium phosphate fluoride (CPP-ACFP) and sodium fluoride (NaF) on artificial caries lesions using DIAGNOdent and micro-computed tomography (μCT). Artificial enamel lesions were prepared on extracted impacted sound mandibular third molars. The samples were randomly allocated to four groups (n = 8): Group 1, P11-4 (Curodont Repair, Credentis AG, Switzerland); Group 2, CPP-ACFP (MI Varnish, GCCo., Japan); Group3, NaF (Duraphat Varnish, Colgate, Colgate-Palmolive, NY, USA); Group 4, artificial saliva (control). The agents were applied to demineralized surfaces according to manufacturers' instructions; all specimens were stored in artificial saliva for 1 month. Demineralization and remineralization on enamel surfaces were analyzed and quantified by DIAGNOdent (KaVo, Germany) and μCT (SkyScan1174, Belgium) for lesion depth/area/volume/mineral density (MD). The remineralization efficacy of the agents was evaluated by DIAGNOdent on 1st, 7th, 30th days and by μCT on 30th day. Data were statistically analyzed by ANOVA, Kruskal-Wallis, T test, and Wilxocon tests. The highest remineralization efficacy findings in all periods were determined in Group 1, followed by Groups 2, 3, and 4. The remineralization findings for fluorescence, MD, lesion depth in Group 1 were found significantly higher (p < 0.01) than Group 3; and no significant differences (p > 0.05) were found between Groups 1-2 and Groups 2-3. The area and volume change values in Groups 1, 2, and 3 have shown no significancy (p > 0.05). A significant correlation (p < 0.01) was found between μCT and DIAGNOdent methods. The data of this study have demonstrated that P11-4 has showed the best remineralization efficacy, followed by CPP-ACFP and NaF. It is concluded that self-assembling peptide-based remineralization agent can be used successfully for biomimetic remineralization of enamel subsurface lesions.

Clinical Performance and Remineralization Potential of Different Biomimitic Materials on White Spot Lesions

Aim: This study was designed to evaluate and compare the re-mineralization potential of different biomimetic materials; self assembling peptide (P11-4), highly concentrated sodium fluoride agent and combination of fluoride, hydroxyapatite and xylitol paste on the white spot lesions. Materials and Methods: This study was conducted on 45 white spot lesions. Each white spot lesion was scored according to severity using the ICDAS II criteria, then assigned into three groups of 15 lesions each according to the re-mineralizing material used; Group A1: 15 lesions were treated with Self assembling peptide (P11-4) (curodont repair), Group A2: 15 lesions were treated with highly concentrated sodium fluoride agent (Lunos® Polierpaste Two in One), Group A3: 15 lesions were treated with fluoride, hydroxyapatite and xylitol paste (Remin Pro forte). Saliva pH was checked every month for three months using CRT buffer. Photographic records were taken before treatment and after treatment then after three months. Patients were recalled after 1 month, 2 months and 3 months of re- mineralizing agents’ application. Data was presented as mean, median, standard deviation (SD). As most of the data was parametric, the differences between groups were evaluated by one way analysis of variance (ANOVA) test. This was followed by Tukey’s post hoc test when ANOVA yielded positive results. The level of significance was set at P < 0.05. Results: the mean percentage change in ICDAS II scores improved for all the three re- mineralizing agents used as compared to baseline. No significant difference was noted at baseline (p=0.54). However, at 3 months the difference between groups was statistically significant, since most of the cases in Remin Pro group recorded score 1 (66.6%), while most of the cases in Curodont and Lunos 2 in 1 group scored 2 (53.3% and 80% respectively). Score 0 recorded (20%) for Remin Pro while (13.3%) scored for Curodont. On the other hand, Lunos polier paste recorded no 0 score. According to Saliva buffer results; as a comparison between the three groups, pH of group (A3: Remin Pro forte) showed higher increase followed by group (A1: Curodont repair) then group (A2: Lunos polierpaste 2 in 1). Conclusions: All the tested materials have varying re-mineralization potential through Remin Pro forte was the most efficient. Self assembling peptides (P11-4) seem to believe in resisting the acid challenge. All agents were clinically efficient in management of white spot lesions

Application of the Self- Assembling Peptide P11-4 for Prevention of Acidic Erosion.

The aim of this study was to use ultrasonography to evaluate the effect of the self-assembling peptide P11-4 on acid erosion prevention. Curodont Repair (CR), which includes peptide P11-4, was used. Rectangular prisms of bovine enamel (4×1×1 mm) were immersed in pure orange juice for a period of 5 minutes six times per day for 28 days. These samples were divided into four groups of six specimens each and treated differently for an additional period of 28 days: 1) baseline group specimens were stored in artificial saliva; 2) CR group specimens were exposed to curodont without acid challenge; 3) NCRA (no curodont+acid challenge) specimens were treated with orange juice without curodont exposure; and 4) CRA (CR+acid challenge) specimens were treated with curodont before treatment with orange juice. The propagation time of longitudinal ultrasonic velocity (UV) was measured. Ultrastructural observation of each tested enamel surface was carried out using field-emission scanning electron microscopy (SEM). The UV data were analyzed using two-way analysis of variance with time and treatment as confounding factors. Post hoc pairwise tests among groups were performed using the Tukey honestly significant difference test. The average UV in intact bovine enamel for the baseline group ranged from 4,483 to 4,549 m/s and did not vary significantly within the test period. The average ultrasonic velocity (UV) in all samples decreased after the initial erosion. The UV in NCRA decreased further over time. Increased UVs were found for CR and CRA. For CR and CRA, there was no significant difference in UV at the end of the experiment from the initial value before erosion. In the results of SEM observation, the CR and CRA groups had similar morphologic features in that etching patterns were not clearly due to precipitation between the enamel rods. From the results of this in vitro study, it might be concluded that applying enamel matrix derivatives and self-assembling peptides on erosive lesions can improve remineralization.

Treatment of Carious Lesions Using Self-Assembling Peptides.

Modern approaches in caries treatment involve lesion management without tissue removal. Regenerative medicine focuses on replacing damaged tissues with biologically similar tissues. This article discusses the scientific evidence and clinical results for self-assembling peptides in modern caries management. The biomimetic remineralization promoted by self-assembling peptide P11-4 has been proven in vitro as an effective therapy for initial caries. P11-4 was rationally designed to promote formation of hydroxyapatite on its surface. The formulation was optimized to ensure the ability of monomeric P11-4 to penetrate past the subsurface lesions and assembly into a biomatrix within. Furthermore, P11-4 has shown that it assembles into fibers within carious lesions, and promotes the remineralization thereof. In a recent clinical study, the safety and efficacy of P11-4 in treatment of initial caries were evaluated. The additional effect of the application of P11-4 (Curodont Repair) was compared to the application of fluoride varnish (Duraphat) alone in active occlusal initial caries lesions on erupting permanent molars. In the 3- and 6-month recalls, the test group showed, both in the laser fluorescence readings and in the clinical assessment of the caries stage and activity, significantly superior lesion regression compared to the control group. No adverse events, medical complications, or allergic reactions related to the treatments were reported. Clinical applicability of treatment was regarded as satisfactory. Patients were happy to receive noninvasive caries treatments. In conclusion, biomimetic mineralization facilitated by P11-4 in combination with fluoride may present a simple, safe, and effective noninvasive treatment for early carious lesions.

Remineralization of Early Carious Lesions using Biomimetic Selfassembling Peptides Versus Fluoride agent. (In vitro and In vivo study)

Objective: The purpose of this study is to evaluate the remineralization potential of the self-assembling peptideP11-4 (Curodont repair) versus highly concentrated fluoride agent (Enamelast) after single & double applications (Atomic Force Microscopy study) and to evaluate the clinical efficacy of both agents in patients with early carious lesions. Materials and methods: Twenty children ranging from 10-16 years of age were selected with at least 2 white lesions (WSL) detected clinically on the buccal surface of permanent anterior teeth, one on each side. Patients were randomly assignedinto 2 groups according to the re-mineralizing agent applied. A1: 20 WSL re-mineralized with Curodont. A2: 20 WSL re-mineralized with Fluoride varnish. Each group was further subdivided into 2 subgroups according to the number of applications with (A1B1):10 WSL treated with Curodont single application, (A1B2): 10 WSL treated with Curodont double applications, (A2B1): 10 WSL treated with fluoride single application and (A2B2): 10 WSL treated with fluoride double applications. Also this study was carried on 40 freshly extracted young upper or lower premolars. Teeth were extracted from patients ranging from 14 to 20 years, for orthodontic purpose. Forty enamel samples were prepared from teeth and then examined before and after demineralization and after remineralization with Atomic Force Microscopy (AFM). Results: Both remineralizing agents showed decrease in enamel average roughness after remineralization, howevergroup (A1: Curodont) showed the lowest results. Both groups show gradual decrease in the International Caries Detection Assessment System scores (ICDAS) from the base line to reach the lowest level after 6 months. The best results of ICDAS scores were recorded in subgroup (A1B2: Curodont double application). Both subgroups of curodont repair revealed an extremely significant higher percent increase of radiodensity percentage in comparison to fluoride subgroups. No significant difference between the 2 remineralizaing agents on the pH of saliva. Conclusion: Self-assembling peptides(Curodont repair) was successful as a remineralizing agent in young permanent teeth with white spot lesions.

Measuring the remineralization potential of different agents with quantitative light-induced fluorescence digital Biluminator.

The aim of this study was to investigate the effectiveness of different remineralization agents by quantitative light-induced fluorescence digital BiluminatorTM (QLF-D). Artificial caries lesions were created, and the teeth were divided according to the tested materials: (i) distilled water, (ii) acidulated phosphate fluoride (APF), (iii) Curodont Repair (CR), (iv) ammonium hexafluorosilicate (SiF) and (v) ammonium hexafluorosilicate plus cetylpyridinium chloride (SiF + CPC). After treatment procedures, each of the samples was placed in artificial saliva. After demineralization and 1 and 4 weeks of remineralization procedures, fluorescence loss and lesion areas were measured with QLF-D. Data were statistically analyzed (α = 0.05). The fluorescence values of the demineralized enamel specimens treated with the various agents differed significantly compared with pretreatment values for both 1 and 4 weeks (p&lt;0.05). At 4 weeks, the highest fluorescence gain was calculated in the CR, APF and SiF groups compared with the control (p&lt;0.05). APF, SiF and CR groups yielded greater remineralization ability than SiF + CPC and control groups.

Ultrasonic assessment of the effects of self-assembling peptide scaffolds on preventing enamel demineralization

Objectives. This study evaluates the effect of self-assembling peptide P11-4 (Curodont Repair, CDR) on bovine enamel remineralization by measuring changes in ultrasonic propagation velocity. Methods. Six specimens per group were prepared by sectioning bovine teeth into enamel blocks. These blocks were then immersed in lactic acid buffer solution (pH = 4.75) for 10 min twice a day and stored in artificial saliva. Other specimens were first treated with CDR, followed by a 10-min immersion in the lactic acid buffer solution twice a day, before storage in artificial saliva. The propagation time of longitudinal ultrasonic waves was measured using a pulser/receiver. Six specimens were used for each treatment protocol. The obtained data were statistically analyzed using ANOVA followed by Tukey’s honestly significant difference tests (α = 0.05). Specimens were observed using laser scanning microscopy and scanning electron microscopy. Results. Sonic velocity was found to decrease with time for specimens stored in the demineralizing solution. On the other hand, increases in sonic velocity were found for specimens treated with CDR. These specimens also exhibited signs of mineral deposition. Conclusions. By measuring the ultrasonic propagation velocity, it can be concluded that CDR application has an ability to promote bovine enamel remineralization.