Alkilzy M, Santamaria R M, Schmoeckel J, Splieth C H
1 Department of Preventive and Pediatric Dentistry, Centre for Oral Health, University of Greifswald, Greifswald, Germany.
Adv Dent Res. 2018 Feb;29(1):42-47. doi: 10.1177/0022034517737025.
Modern approaches in caries treatment involve lesion management without tissue removal. Regenerative medicine focuses on replacing damaged tissues with biologically similar tissues. This article discusses the scientific evidence and clinical results for self-assembling peptides in modern caries management. The biomimetic remineralization promoted by self-assembling peptide P11-4 has been proven in vitro as an effective therapy for initial caries. P11-4 was rationally designed to promote formation of hydroxyapatite on its surface. The formulation was optimized to ensure the ability of monomeric P11-4 to penetrate past the subsurface lesions and assembly into a biomatrix within. Furthermore, P11-4 has shown that it assembles into fibers within carious lesions, and promotes the remineralization thereof. In a recent clinical study, the safety and efficacy of P11-4 in treatment of initial caries were evaluated. The additional effect of the application of P11-4 (Curodont Repair) was compared to the application of fluoride varnish (Duraphat) alone in active occlusal initial caries lesions on erupting permanent molars. In the 3- and 6-month recalls, the test group showed, both in the laser fluorescence readings and in the clinical assessment of the caries stage and activity, significantly superior lesion regression compared to the control group. No adverse events, medical complications, or allergic reactions related to the treatments were reported. Clinical applicability of treatment was regarded as satisfactory. Patients were happy to receive noninvasive caries treatments. In conclusion, biomimetic mineralization facilitated by P11-4 in combination with fluoride may present a simple, safe, and effective noninvasive treatment for early carious lesions.
现代龋齿治疗方法包括在不切除组织的情况下进行病变管理。再生医学专注于用生物相似组织替代受损组织。本文讨论了自组装肽在现代龋齿管理中的科学证据和临床结果。自组装肽P11 - 4促进的仿生再矿化已在体外被证明是治疗早期龋齿的有效疗法。P11 - 4经过合理设计，以促进其表面羟基磷灰石的形成。该配方经过优化，以确保单体P11 - 4能够穿透表层下病变并在内部组装成生物基质。此外，P11 - 4已表明它能在龋损内组装成纤维，并促进其再矿化。在最近的一项临床研究中，评估了P11 - 4治疗早期龋齿的安全性和有效性。将P11 - 4（Curodont修复剂）的应用与单独应用氟化物漆（Duraphat）治疗正在萌出的恒牙合面早期龋齿病变的额外效果进行了比较。在3个月和6个月的复诊中，与对照组相比，试验组在激光荧光读数以及龋齿阶段和活性的临床评估中均显示出明显更好的病变消退情况。未报告与治疗相关的不良事件、医疗并发症或过敏反应。治疗的临床适用性被认为是令人满意的。患者乐于接受非侵入性龋齿治疗。总之，P11 - 4与氟化物联合促进的仿生矿化可能为早期龋损提供一种简单、安全且有效的非侵入性治疗方法。
