Analysis of efficacy of the self-assembling peptide based remineralization agent on artificial enamel lesions

Aim: The objective of this in-vitro study was to analyze and compare the biomimetic remineralizing efficacy of the self-assembling peptide (P11-4) with agents containing casein phoshopeptide-amorhous calcium phosphate fluoride (CPP-ACFP) and sodium fluoride (NaF) on artificial caries lesions using DIAGNOdent and micro-computed tomography (μCT). Methods: Artificial enamel lesions were prepared on extracted impacted sound mandibular third molars.The samples were randomly allocated to 4 groups(n=8):Group1;P11-4 (CurodontRepair, CredentisAG, Switzerland), Group2;CPP-ACFP(MIVarnish,GCCo.,Japan),Group3;NaF(DuraphatVarnish,Colgate,USA),Group4: artificial saliva(control). The agents were applied to demineralized surfaces according to manufacturers' instructions; all specimens were stored in artificial saliva for 1 month. Demineralization and remineralization on enamel sufaces were analysed and quantified by DIAGNOdent(KaVo,Germany) and μCT(SkyScan1174,Belgium) for lesion depth/ area/volume/mineral density(MD). The remineralization efficacy of the agents was evaluated by DIAGNOdent on 1st,7th,30th days and by μCT on 30th day. Data was statistically analysed by ANOVA, Kruskal-Wallis,T test, Wilxocon tests. Results:The highest remineralization efficacy findings in all periods were determined in Group1, followed by Group2, Group3 and Group4. The remineralization findings for fluorescence, MD, lesion depth in Group1 were found significantly higher(p<0.01) than Group3; and no significant differences (p>0.05) were found between Groups1-2, Groups 2-3. The area and volume change values in Groups 1,2 and 3 have shown no significancy(p>0.05). A significant correlation(p<0.01) was found between μCT and DIAGNOdent methods.Conclusion: The data of this study has demonstrated that P11-4 has showed the best remineralization efficacy, followed by CPP-ACFP and NaF. It is concluded that self-assembling peptide based remineralization agent can be used successfully for biomimetic remineralization of enamel subsurface lesions.