Biomimetic Remineralization Using Self-Assembling Peptide P11-4 in the Prevention and Treatment of Early Carious Lesions in Primary Anterior Teeth: An In-Vivo and In-Vitro Study

Abstract

The emergence of the minimal invasive dentistry philosophy has clearly emphasized on the need for clinically effective materials and measures capable of remineralizing early enamel caries lesions. Although fluoride has been the gold standard of remineralization of white spot lesions (WSL), some studies have claimed that it is capable of remineralizing outer 30ųm of enamel surface only, while other studies stated that its ability to reduce caries prevalence in some populations is reaching a plateau. Therefore, alternative remineralizing materials have been recently developed claiming that these have advantages over the remineralization using fluoride. These include their ability to promote deeper remineralization, reduce potential risks associated with the use of highly fluoridated products, and to control dental caries over a lifetime. That’s why studies have been lately focusing on the development of new remineralizing materials that are capable of remineralizing subsurface carious lesions. Among these materials, the biomimetic remineralization concept has emerged. This concept states that specific materials are capable of mimicking the natural mineralization process of the enamel structure, namely the biomineralization process and therefore was named ‘biomimetic remineralization’. Self-assembling peptide P11-4 (SAP P11-4) and nanohydroxyapati