Effects of Self-Assembling Peptide P11-4, Fluorides, and Caries Infiltration on Artificial Enamel Caries Lesions in vitro

The application of a self-assembling peptide on noncavitated caries lesions is supposed to be a feasible approach to facilitate remineralization and mask their unfavorable appearance. However, demineralizing conditions are common in the oral environment, so the aim of this pH-cycling study was to compare recommended and novel treatment methods regarding their ability to hamper demineralization and as a consequence mask artificial enamel caries lesions. Artificial caries lesions were prepared in bovine enamel and randomly allocated to 11 groups (n = 22). Treatments before pH-cycling were as follows: the application of a self-assembling peptide (Curodont (TM) Repair [C]), a low-viscosity resin (Icon (R) [I]), 2 fluoride solutions (10,000 ppm F-: Elmex fluid [E] and 43,350 ppm F-: Tiefenfluorid (R) [T]), and no intervention (N). During pH-cycling (28 days, 6 x 60 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 x/day) with either fluoride-free (named e.g., C-0) or NaF (1,100 ppm F-; e.g., C-1) dentifrice slurry. In another subgroup specimens were pH-cycled but not brushed (N-NB). Differences in integrated mineral loss (Delta Delta Z), lesion depth (Delta LD), and colorimetric values (Delta Delta E) were calculated between values after pre-demineralization, surface treatment, and pH-cycling. Specimens of C-0, C-1, N-NB, N-0, N-1, T-0, and E-0 showed significantly increased Delta Z and LD values after pH-cycling (p <= 0.003; paired t test). C-0, C-1, N-NB, and N-0 showed significantly higher changes in Delta Delta Z than E-1, I-0, I-1, and T-1 (p < 0.001; ANOVA). Significantly reduced colorimetric values could only be observed for I-1, I-0, E-1, and E-0 after treatment and after pH-cycling (p <= 0.027; paired t test). In conclusion, under the conditions chosen only the application of a low-viscosity resin could mask caries lesions significantly, whereas self-assembling peptides could neither inhibit lesion progression nor mask the lesions considerably. (C) 2017 S. Karger AG, Basel