Introduction: Decades of research has helped to increase our knowledge of dental caries and reduce its prevalence. However, according to World Oral Health report, dental caries still remains a major dental disease. Fluoride therapy has been utilised in a big way to halt caries progression, but has been met with limitations. This has paved the way for the development of newer preventive agents that can function as an adjunct to fluoride or independent of it.
Aim: The purpose of the present study was to evaluate the ability of Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CPP ACPF), Bioactive Glass (BAG), fluoride enhanced Hydroxyapatite (HA) gel and self-assembling peptide P11-4 to remineralise artificial carious lesions in enamel in vitro using a 30 day pH cycling model through surface microhardness analysis and SEM.
Materials and methods: Sixty enamel samples were divided into five groups of 12 samples each. The control Group A consisted of intact enamel samples, Group B: CPP-ACPF (Tooth Mousse Plus), Group C: BAG (SHY- NM), Group D: fluoride enhanced HA gel (ReminPro) and Group E: Self-assembling peptide P11-4 (Curodont Protect). All groups excluding the control group were subjected to demineralisation following which four of these groups were remineralised using the four remineralising agents. The treated groups were subjected to pH cycling over a period of 30 days. This was followed by assessment of surface microhardness and SEM for qualitative evaluation of surface changes. The results were analysed by One-Way Analysis Of Variance (ANOVA). Multiple comparisons between groups were performed by paired t-test and post-hoc Tukey test.
Results: The results of the study revealed that remineralisation of enamel was the highest in samples of Group E (Self assembling peptide P11-4) followed by Group B (CPP-ACPF), Group C (BAG) and Group D (fluoride enhanced HA gel). There was a significant difference (p<0.05) in the remineralising ability between the self assembling peptide P11-4 group and BAG and fluoride enhanced HA gel group. Although no significant difference was observed between the self assembling peptide P11-4 and CPP-ACPF group, the self assembling peptide P11-4 remineralised the enamel lesions more effectively. SEM photomicrographs of the test groups demonstrated either amorphous crystals or particles scattered on the surface or lines of remineralisation along the prismatic borders.
Conclusion: Self assembling peptide P11-4 demonstrated promising results by effectively and significantly remineralising the enamel lesions as compared to other test agents.
Keywords: Dental caries; Fluoride; Microhardness; Remineralisation.
Comparative Evaluation of Remineralizing Efficacy of Biomimetic Self-Assembling Peptide on Artificially Induced Enamel Lesions: An in vitro StudyD Kamal et al. J Conserv Dent 21 (5), 536-541. PMID 30294117.Self-assembling peptide confers the highest remineralizing efficacy compared to fluoride and CPP-ACPF, showing a promising, noninvasive regeneration potential. Furthermor …
Enamel Remineralization Assessment After Treatment With Three Different Remineralizing Agents Using Surface Microhardness: An in Vitro StudyS Shetty et al. J Conserv Dent 17 (1), 49-52. PMID 24554861.Casein phosphopeptide with fluoride is a promising material for remineralization of enamel subsurface lesions.
Effect of Fluoride, Casein Phosphopeptide-Amorphous Calcium Phosphate and Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride on Enamel Surface Microhardness After Microabrasion: An in Vitro StudyG Ahmadi Zenouz et al. J Dent (Tehran) 12 (10), 705-11. PMID 27252753.All the remineralizing agents were effective for rehardening the enamel after microabrasion. The CPP-ACP and CPP-ACPF pastes are effective, but to a lesser extent than ne …
Treatment of Carious Lesions Using Self-Assembling PeptidesM Alkilzy et al. Adv Dent Res 29 (1), 42-47. PMID 29355413. - ReviewModern approaches in caries treatment involve lesion management without tissue removal. Regenerative medicine focuses on replacing damaged tissues with biologically simil …
Medical Model in Caries ManagementMJY Yon et al. Dent J (Basel) 7 (2). PMID 30939816. - ReviewThe current mode of dental caries management mainly operates through irreversible and symptomatic treatment by means of drilling and filling, while caries prevention is l …
Cited by 5 PubMed Central articles
Evaluation of the Efficacy of Casein Phosphopeptide-Amorphous Calcium Phosphate on Remineralization of White Spot Lesions in Vitro and Clinical Research: A Systematic Review and Meta-AnalysisX Ma et al. BMC Oral Health 19 (1), 295. PMID 31888600.Within the limitations of this meta-analysis, CPP-ACP exhibited excellent remineralization effects evaluated in clinical research and in vitro, indicating outstanding res …
Mechanisms of Bioactive Glass on Caries Management: A ReviewLL Dai et al. Materials (Basel) 12 (24). PMID 31842454. - ReviewThis review investigates the mechanisms of bioactive glass on the management of dental caries. Four databases (PubMed, Web of Science, EMBASE (via Ovid), Medline (via Ovi …
Effect of the Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CPP-ACPF) and Photobiomodulation (PBM) on Dental Hypersensitivity: A Randomized Controlled Clinical TrialMI Guanipa Ortiz et al. PLoS One 14 (12), e0225501. PMID 31790452.After one-month follow-up, the association of CPP-ACPF with PBM was effective in the reduction of DH and promoted a positive impact on the HRQL of the participants of thi …
Randomised in Situ Clinical Trial Investigating Self-Assembling Peptide Matrix P11-4 in the Prevention of Artificial Caries LesionsA Jablonski-Momeni et al. Sci Rep 9 (1), 269. PMID 30670760.The aim was to investigate the ability of self-assembling Peptide P11-4 Matrix (SAPM) to remineralize artificial initial caries lesions compared to the use of fluoride va …
Comparative Evaluation of Remineralization Potential of Casein Phosphopeptide- Amorphous Calcium Fluoride Phosphate and Novamin on Artificially Demineralized Human Enamel: An In vitro StudyV Manoharan et al. Contemp Clin Dent 9 (Suppl 1), S58-S63. PMID 29962765.Even though both CPP-ACFP and Novamin showed remineralization potential, remineralization was found to be higher in the samples treated with CPP-ACFP.