Kamal Dina, Hassanein Hassan, Elkassas Dina, Hamza Heba
Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
Heidelberg University, Heidelberg, Germany.
J Clin Exp Dent. 2020 Feb 1;12(2):e161-e168. doi: 10.4317/jced.56295. eCollection 2020 Feb.
Self-assembling peptide has been recently introduced to promote hard tissue regeneration for treating early non-cavitated carious lesions. This study investigates the efficacy of biomimetic self-assembling peptide (P11-4) on enamel remineralization combined with CPP-ACPF or fluoride.
Artificial enamel lesions were created on buccal surface of 60 specimens and were randomly assigned to six groups according to the remineralizing agent: G1-(Control, artificial saliva), G2-(Fluoride varnish), G3-(CPP-ACPF varnish), G4-(Self-assembling peptide), G5-(Self-assembling peptide+fluoride varnish), G6-(Self-assembling peptide+CPP-ACPF varnish). All products were applied according to manufacturer's instructions and specimens were stored in a daily renewed artificial saliva. Surface microhardness (SMH) and scanning electron microscope (SEM) were assessed at baseline, after demineralization, 1 week and 4 weeks storage. SMH values were analyzed using ANOVA and Tukey's post-hoc test.
The highest statistically significant SMH values were found in G6 followed by G5, G4, G2 and G3 while the lowest values were found in G1. No statistically significant difference was found between G5 and G6. Also, no statistically significant difference was found between G2 and G3. SEM showed that G4, G5, G6 resulted in more pronounced remineralization, reversing the demineralized enamel fish scale pattern compared to G2 and G3 after 1 week and 4 week remineralization.
Complementary effect was obtained after combining self-assembling peptide with CPP-ACPF or fluoride showing the highest remineralizing potential early after 1 week and even after 4 weeks compared to when each agent used alone. Added benefits can be obtained through combining self-assembling peptide with other remineralzing agents allowing faster and enhanced regeneration of non-cavitated caries lesions. Enamel regeneration, biomimetic remineralization, self-assembling peptide, CPP-ACPF, fluoride.
自组装肽最近被引入用于促进硬组织再生以治疗早期非龋洞性龋损。本研究调查了仿生自组装肽（P11 - 4）与酪蛋白磷酸肽 - 无定形磷酸钙氟化物（CPP - ACPF）或氟化物联合用于牙釉质再矿化的疗效。
在60个标本的颊面制备人工牙釉质病变，并根据再矿化剂随机分为六组：G1 - （对照组，人工唾液），G2 - （氟化物漆），G3 - （CPP - ACPF漆），G4 - （自组装肽），G5 - （自组装肽 + 氟化物漆），G6 - （自组装肽 + CPP - ACPF漆）。所有产品均按照制造商说明应用，标本储存在每日更新的人工唾液中。在基线、脱矿后、储存1周和4周时评估表面显微硬度（SMH）和扫描电子显微镜（SEM）。使用方差分析和Tukey事后检验分析SMH值。
在G6组中发现具有最高统计学显著意义的SMH值，其次是G5、G4、G2和G3组，而在G1组中发现最低值。在G5和G6组之间未发现统计学显著差异。此外，在G2和G3组之间也未发现统计学显著差异。SEM显示，与再矿化1周和4周后的G2和G3组相比，G4、G5、G6组导致更明显的再矿化，使脱矿牙釉质的鱼鳞状图案得到逆转。
自组装肽与CPP - ACPF或氟化物联合使用后获得了互补效应，与单独使用每种试剂相比，在1周后甚至4周后显示出最高的再矿化潜力。通过将自组装肽与其他再矿化剂联合使用可以获得额外的益处，从而使非龋洞性龋损更快且更有效地再生。牙釉质再生、仿生再矿化、自组装肽、CPP - ACPF、氟化物。
