Preventing and Arresting Primary Tooth Enamel Lesions Using Self- Assembling Peptide P-11-4 In Vitro

Objectives: To evaluate self-assembling peptides (SAP) for caries prevention and arrest in primary tooth enamel in vitro. Materials and Methods: Overall, 180 extracted primary teeth were used. In the prevention experiment (n = 20 samples per group), self-assembling peptide for prevention (SAPP), fluoride varnish/mouthwash (FV/FMW), casein-phosphopeptide amorphous-calcium phosphate (CPP-ACP), and nanohydroxyapatite (nHA) were applied. Samples were subjected to a demineralizing pH cycling for 14 days. In the arrest experiment (n = 15/group), 60 samples were pre-demineralized; induced lesions were treated using self-assembling peptide for repair (SAPR), FV, CPP-ACP plus fluoride, and resin infiltration (RI) and submitted to pH cycling. Mineral loss and its differences as well as lesion depth were determined using transversal microradiography. Numerical data were tested for normality using Shapiro-Wilk's test and were compared using Kruskal-Wallis test followed by pairwise comparisons utilizing multiple Mann-Whitney U tests with Bonferroni correction. The significance level was set at P < 0.05 within all tests. Results: FV (median: -46.3 [interquartile range: 175.52] vol% x mu m) and FMW (-33.35 [124.65] vol% x mu m) prevented caries significantly more effectively than all other groups (P < 0.001), which did not show significant preventive effects. RI (median: 4949.70 [1637.20] vol% x mu m) and FV (median = 6076.05 [5190.08] vol% x mu m) arrested lesions, whereas SAPR and CPP-ACPF did not show such arrest. Conclusions: FV and FMW showed the largest caries-preventive effect, whereas RI and FV arrested lesion progression in primary tooth enamel in vitro.