Impact of self-assembling peptides in remineralisation of artificial early enamel lesions adjacent to orthodontic brackets

Enamel demineralisation can occur as a side effect during orthodontic treatment with fixed appliances. This study aimed to evaluate the efficacy of the self-assembling peptide P-11-4 for remineralisation combined with fluorides, compared to application of fluoride varnish alone. De- and remineralisation was assessed by Quantitative light-induced fluorescence (QLF). Orthodontic brackets were bonded on 108 human enamel samples and white spot lesions were created. The samples were allocated randomly into three groups: Group I received no treatment, group II had a single application of fluoride varnish (22,600 ppm), and group III was treated with P-11-4 following a single application of fluoride varnish. Quantitative light-induced fluorescence (QLF) measurements were performed at baseline, after demineralisation and after storage in remineralisation solution for 7 and 30 days. Non-parametric tests (Kruskal-Wallis test and Friedman test) were used for further analysis. After demineralisation, all samples showed a median Delta F -9.38%+/- 2.79. After 30 days median Delta F values were as followed: group I=-9.04%+/- 2.51, group II=-7.89 +/- 2.07, group III=-6.08%+/- 2.79). The median Delta F values differed significantly between all groups at all investigation times (p<0.00001). Application of P-11-4 with fluoride varnish was superior to the use of fluorides alone for remineralisation of enamel adjacent to brackets.