Preventing and Arresting Primary Tooth Enamel Lesions Using Self- Assembling Peptide P11-4 In Vitro

Nour Wahba; Falk Schwendicke; Mohamed A Kamel; Gehan Allam; Noha Kabil; Karim Elhennawy

doi:10.4103/jispcd.JISPCD_257_21

Preventing and Arresting Primary Tooth Enamel Lesions Using Self- Assembling Peptide P₁₁-4 In Vitro

J Int Soc Prev Community Dent. 2022 Jan 29;12(1):58-70. doi: 10.4103/jispcd.JISPCD_257_21. eCollection 2022 Jan-Feb.

Authors

Nour Wahba^{1

2}, Falk Schwendicke¹, Mohamed A Kamel³, Gehan Allam^{2

4}, Noha Kabil^{2

4}, Karim Elhennawy⁵

Affiliations

¹ Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Germany.
² Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
³ Department of Operative Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
⁴ Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, British University in Egypt, Cairo, Egypt.
⁵ Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Germany.

Abstract

Objectives: To evaluate self-assembling peptides (SAP) for caries prevention and arrest in primary tooth enamel in vitro.

Materials and methods: Overall, 180 extracted primary teeth were used. In the prevention experiment (n = 20 samples per group), self-assembling peptide for prevention (SAPP), fluoride varnish/mouthwash (FV/FMW), casein-phosphopeptide amorphous-calcium phosphate (CPP-ACP), and nanohydroxyapatite (nHA) were applied. Samples were subjected to a demineralizing pH cycling for 14 days. In the arrest experiment (n = 15/group), 60 samples were pre-demineralized; induced lesions were treated using self-assembling peptide for repair (SAPR), FV, CPP-ACP plus fluoride, and resin infiltration (RI) and submitted to pH cycling. Mineral loss and its differences as well as lesion depth were determined using transversal microradiography. Numerical data were tested for normality using Shapiro-Wilk's test and were compared using Kruskal-Wallis test followed by pairwise comparisons utilizing multiple Mann-Whitney U tests with Bonferroni correction. The significance level was set at P < 0.05 within all tests.

Results: FV (median: -46.3 [interquartile range: 175.52] vol% × µm) and FMW (-33.35 [124.65] vol% × µm) prevented caries significantly more effectively than all other groups (P < 0.001), which did not show significant preventive effects. RI (median: 4949.70 [1637.20] vol% × µm) and FV (median = 6076.05 [5190.08] vol% × µm) arrested lesions, whereas SAPR and CPP-ACPF did not show such arrest.

Conclusions: FV and FMW showed the largest caries-preventive effect, whereas RI and FV arrested lesion progression in primary tooth enamel in vitro.

Keywords: Biomimetic remineralization; caries; microradiography; prevention; primary teeth; self-assembling peptides.