Clinical evaluation of biomimetic self-assembling peptide (p11-4) in the remineralization of early enamel caries in permanent teeth
Sara A. Mohamed, Ahmed I. Eldosoky, Nahed S. ShokerBackground
Remineralization of early carious lesions is a noninvasive process aimed to restore lost minerals without need for drilling or restoration. Early intervention at early stage can stop or reverse caries progression, preserve tooth structure, and improve esthetics.
Aim
This study aimed to evaluate clinically the remineralizing efficacy of self-assembling peptide (SAP P11-4) on early enamel carious lesions of permanent anterior teeth.
Patients and methods
Fifty anterior permanent teeth were selected from 50 children aged from 10 to 14 years old and divided into two groups; SAP p11-4 study group and fluoride varnish control group. Early enamel carious lesions were assessed according to ICDAS II (ranging between 1 and 2) and DIAGNOdent pen, the measurements were recorded as baseline data. Labial surfaces of the teeth were cleaned. In SAP group, pretreatment with acid etching then SAP applied as manufacturer’s instructions, while fluoride varnish was deposited as a thin film with a brush without any surface pretreatments. The treated teeth were clinically evaluated quantitively and qualitatively at 1, and 6 months follow-up periods.
Results
SAP p11-4 showed significant reduction in DIAGNOdent values at follow up periods, indicating immediate remineralization. While fluoride varnish showed limited reduction over 6 months follow up periods. Moreover, both groups showed reduction in DIAGNOdent values over 6 months, but SAP p11-4 showed statistically greater reduction compared to fluoride varnish at 1, 3, and 6 months indicating its sustained and progressive efficacy. Regarding ICDAS II scores, the results showed a significant and progressive improvement in early carious lesions subjected to SAP p11-4 over a 6-month, while fluoride varnish group showed a slower effect. Also, SAP p11-4 was highly statistically significant at 3 and 6 months follow-up compared to fluoride group.
Conclusion
Treatment with SAP p11-4 provides a noninvasive, fast, and simple approach for managing early carious lesions in young permanent anterior teeth, promoting biomimetic subsurface remineralization superior to fluoride varnish.