Remineralization effects of self-assembling peptide P11-4 associated with three materials on early enamel carious lesions: An in vitro study

The aim of this study was to assess the remineralization of enamel caries lesions using the self-assembling peptide P-11-4 associated with different materials. Artificial early enamel lesions were prepared on 154 primary teeth. The samples were randomly divided into eight groups: (1) control, (2) P-11-4, (3) fluoridate toothpaste (FT), (4) P-11-4 + FT, (5) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), (6) P-11-4 + CPP-ACP, (7) fluoridate bioactive glass toothpaste (BT), and (8) P-11-4 + BT. The surface enamel microhardness (EMH) and energy-dispersive X-ray spectroscopy (EDS) of the teeth were then measured at the baseline, after demineralization, and after 28 days of remineralization. The enamel surfaces were assessed by field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM). The data were analyzed with one-way analysis of variance (ANOVA) (p < .05). EMH after demineralization was significantly lower than the baseline value (p < .001). The interventions led to an enhanced percentage of EMH recovery (%REMH), which was higher in Groups 6 and 7. There was no significant difference between Groups 3 and 4. Groups 1 and 2 had the lowest %REMH. The mean calcium/phosphate weight percentage ratio of P-11-4 was significantly lower than the others (p < .001). The FESEM and AFM images revealed mineral deposition on the eroded enamel and reductions in surface roughness in Groups 5 and 7.

Automated summary

This study found that the combination of P-11-4 with different materials can promote remineralization of enamel caries lesions, with P-11-4 and fluoridate bioactive glass toothpaste showing the best effects. There was no significant difference between the groups using P-11-4 with fluoridate toothpaste and casein phosphopeptide-amorphous calcium phosphate. Additionally, the calcium/phosphate weight percentage ratio of P-11-4 was significantly lower than other groups.