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Nath SJC, Fu Y, Li KC, Loho T, Loch C, Ekambaram M. A Comparison of the Enamel Remineralisation Potential of Self-Assembling Peptides. Int Dent J 2024; 74:187-194. [PMID: 37743135 PMCID: PMC10988264 DOI: 10.1016/j.identj.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/19/2023] [Accepted: 07/04/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The aim of this research was to compare the efficacy of the remineralising potential of self-assembling peptides (SAPs): Curodont Repair (P11-4), P26, and leucine-rich amelogenin peptides (LRAP) with the standard 5% NaF varnish (Duraphat) on early enamel caries lesions (EECLs). METHODS A demineralising solution (DS) was used to create artificial EECLs in human dental enamel specimens, which were randomly allocated to treatment groups: P11-4; P26 solution; LRAP solution; 5% NaF varnish; and deionised water (DIW). Each specimen was subjected to 8 days of pH cycling. Specimens from each test group were subjected to microcomputed tomography (micro-CT) and nanomechanical testing to assess mineral density (MD), hardness (H), and elastic modulus (EM) properties of sound, demineralised, and treated enamel. RESULTS The mean MD percentage gain was highest in the P26 and P11-4 groups, followed by the LRAP, 5% NaF varnish, and DIW groups. There were statistically significant differences amongst groups. In the outer layer of EECLs, the EM and H were highest in P26 and P11-4 groups, followed by the LRAP and 5% NaF varnish. In the inner layer of EECLs, the EM and H were highest in P11-4 and P26 groups, indicative of enhanced penetration and remineralisation of the deeper parts of the artificial EECLs. CONCLUSIONS P26 and P11-4 SAPs are more effective than 5% NaF varnish in remineralising the depth of EECLs.
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Affiliation(s)
- Suneil Jason Chand Nath
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Yipeng Fu
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand; The Fifth Outpatient Department, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Kai Chun Li
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Thomas Loho
- Faculty of Engineering, Chemical and Materials Engineering, University of Auckland, New Zealand
| | - Carolina Loch
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Manikandan Ekambaram
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
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Xavier GD, Thomas G, Jose S, Vivek VJ, Selvam K, Ramakrishnan A. Comparative evaluation of remineralization potential of four different remineralization agents on human enamel: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:29-35. [PMID: 38389734 PMCID: PMC10880471 DOI: 10.4103/jcde.jcde_113_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/17/2023] [Accepted: 10/26/2023] [Indexed: 02/24/2024]
Abstract
Aim The study aimed to assess the remineralizing potential of four different commercially available agents using a Scanning Electron Microscope (SEM), energy dispersive X-ray (EDX) analysis, and Vickers Microhardness (VMH) Test. Materials and Methods Forty-four specimens (n = 11 per group) were prepared from extracted teeth. A window of 6 mm × 4 mm was made on all the specimens that represented three zones, namely, sound enamel, demineralized enamel, and remineralized enamel. The zone for demineralized enamel was subjected to four different remineralizing agents; casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), tricalcium phosphate fluoride (TCP-F), calcium sucrose phosphate (CSP), and self-assembling peptide (P11-4). Remineralization (REM) was assessed using VMH; the structural changes were assessed using SEM that was analyzed using EDX analysis. The specimens were subjected to a newer regimen of demineralization. One-way ANOVA followed by post hoc Tukey test was used with a level of significance at P ≤ 0.05. Results There were no significant differences in VMH between the groups for sound enamel (P = 0.472) and demineralized enamel (P = 0.116). VMH was statistically significantly more for P11-4 and the least for CPP-ACPF (P = 0.011). A post hoc analysis revealed higher VMH for P11-4 compared to CPP-ACPF (P = 0.014) and TCP-F (P = 0.035). SEM showed a homogeneous layer of minerals for all groups except CPP-ACPF. TCP-F reported a higher degree of REM, followed by P11-4 as assessed using EDX analysis. Conclusion Self-assembling peptide (P11-4) exhibited a higher degree of REM than other remineralizing agents followed by CSP.
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Affiliation(s)
- Giftlin Denny Xavier
- Department of Conservative Dentistry and Endodontics, Sri Venkateshwaraa Dental College, Puducherry, India
| | - George Thomas
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences and Hospital, Mahé, Kerala, India
| | - Sunil Jose
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences and Hospital, Mahé, Kerala, India
| | | | - Kanimozhi Selvam
- Department of Prosthodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Puducherry, India
| | - Ashish Ramakrishnan
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences and Hospital, Mahé, Kerala, India
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Rathore K, Patnana AK, Chugh VK, Chugh A, Kumar P. Self-assembling peptides for managing white spot lesions: a systematic review and meta-analysis. Eur Arch Paediatr Dent 2023; 24:519-531. [PMID: 37702901 DOI: 10.1007/s40368-023-00821-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/03/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE The primary objective of the review was to assess the effectiveness of self-assembling P11-4 peptide (SAP) with or without any fluoride agents (FA) in remineralization of the White spot lesions (WSLs)/incipient carious lesions (ICLs) compared to other enamel remineralizing agents/non-intervention/placebo. METHODS Human RCTs published during the period from 1st January 2000-30th June 2021 were searched in the electronic bibliographic databases and scanning reference lists of articles from PubMed, Google Scholar, and The Cochrane Central Register of Controlled Trials. The Risk-of-Bias was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) tool for all included studies. The statistical heterogeneity between studies was assessed by the Cochrane Q test and I2 test. A random-effects model was used considering the variations in true effects size between the included studies. The quality of the evidence for remineralizing effectiveness of SAP/SAP + FA was done using the GRADEpro GDT software which employs GRADE. RESULTS Four out of eight included trials were assessed to have "high risk" of bias. Mean difference for Laser fluorescence outcome assessment method (SAP v/s FA) was - 4.89 (95% CI: - 17.35 to 7.57; p = 0. 44; I2 = 89%). The combined risk ratio observed through Nyvad criteria (SAP v/s FA) was 0.12 (95% CI: 0.01-1.59; p = 0.11; I2 = 71%). Mean difference for Laser fluorescence outcome assessment method (SAP + FA v/s FA) was - 11.52 (95% CI: - 14.43 to - 8.61; p = < 0.001;I2 = 0%). The combined risk ratio for ICDAS outcome assessment method (SAP + FA v/s FA) was 0.27 (95% CI: 0.03-2.84; p = 0.15; I2 = 53%). CONCLUSION Considering the results observed from the included trials we are uncertain whether SAP/SAP + FA increases/decreases the remineralizing/regeneration of WSLs/ICLs.
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Affiliation(s)
- K Rathore
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India.
| | - A K Patnana
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
- Department of Dentistry, All India Institute of Medical Sciences, Rajkot, Gujarat, 360006, India
| | - V K Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - A Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - P Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
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Godenzi D, Bommer C, Heinzel-Gutenbrunner M, Horst Keeper J, Peters K. Remineralizing potential of the biomimetic P 11-4 self-assembling peptide on noncavitated caries lesions: A retrospective cohort study evaluating semistandardized before-and-after radiographs. J Am Dent Assoc 2023; 154:885-896.e9. [PMID: 37642611 DOI: 10.1016/j.adaj.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Self-assembling peptide (SAP) P11-4 was introduced to treat initial caries lesions by means of guiding hydroxyapatite regeneration within the lesion. The objective of this study was to assess its effectiveness in a practical clinical setting. METHODS Caries lesions in permanent teeth treated with monomeric and polymeric SAP P11-4 from May 2015 through October 2020 were retrospectively analyzed at lesion and child levels by means of bite-wing radiography for changes in stage and cavitation and restoration. RESULTS Two hundred and nineteen children aged 10 through 19 years with a total of 405 proximal lesions in posterior teeth were followed from 0.4 through 5.5 years (median, 7 months; interquartile range, 6-19 months). Regression occurred in 37% of stage RA1 (radiolucency in the outer one-half of enamel) (95% CI, 31% to 44%), 38% of stage RA2 (radiolucency in the inner one-half of enamel plus or minus the enamel-dentin junction) (95% CI, 30% to 45%), and 40% of stage RA3 (radiolucency limited to the outer one-third of dentin) (95% CI, 16% to 68%) lesions. The proportion of lesions with no cavitation was 0.96 (95% CI, 0.94 to 0.98) after 1 year and 0.91 (95% CI, 0.88 to 0.95) after 2 years. CONCLUSIONS Real-world clinical data indicate that SAP P11-4 can lead to recovery and a healthier tooth stage. PRACTICAL IMPLICATIONS SAP P11-4 is a safe treatment for initial caries lesions in permanent teeth that remineralizes in the deepest zone of the lesion and can be introduced easily into routine dental practice.
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Shah SV, Kibbe LJ, Heaton LJ, Desrosiers C, Wittenborn J, Filipova M, Zaydenman K, Keeper JH. Framework for fiscal impact analysis of managing initial caries lesions with noninvasive therapies. J Am Dent Assoc 2023; 154:897-909.e6. [PMID: 37770132 DOI: 10.1016/j.adaj.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Evidence-based noninvasive caries therapies for initial caries lesions are available in the United States. Fundamental differences between noninvasive therapies and the traditional surgical dental approach warrant a study of the financial scalability. METHODS The financial costs and benefits of fee-for-service clinics and payors were compared across 11 scenarios simulating the treatment of 1,000 initial caries lesions during a 3-year period. The scenarios included varying combinations of noninvasive therapies (that is, silver diamine fluoride, self-assembling peptide P11-4, and glass ionomer therapeutic sealants), no treatment, and various rates of 1- through 3-surface restorations to an estimated 2022 practice model. We used a decision tree microsimulation model for deterministic and probabilistic sensitivity analyses. We derived assumptions from an initial lesion and noninvasive therapy-focused cohort study with operations data from 16 sites accepting Medicaid in Alabama as a case study and clinical data from all 92 sites. RESULTS In comparison with the 2022 practice model assumed for this study, scenarios that produce mutually beneficial results for payors' savings and clinics' net profits and profit margins include self-assembling peptide P11-4, silver diamine fluoride on nonesthetic surfaces, and a mix of 3 noninvasive therapies. When considering the limited resources of chair and clinician time, the same scenarios, as well as silver diamine fluoride with restorations, emerged with substantially higher clinic net profit. CONCLUSIONS Hypothetical scenarios that include noninvasive therapies and minimize restorations achieve improved outcomes for all parties. PRACTICAL IMPLICATIONS Payors and clinicians should explore and implement noninvasive caries therapies to improve oral health for all. This study was registered at ClinicalTrials.gov. The registration number is NCT04933331.
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Atteya SM, Amer HA, Saleh SM, Safwat Y. Self-assembling peptide and nano-silver fluoride in remineralizing early enamel carious lesions: randomized controlled clinical trial. BMC Oral Health 2023; 23:577. [PMID: 37598194 PMCID: PMC10439642 DOI: 10.1186/s12903-023-03269-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/29/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Nanoparticles and regenerative biomineralization are new caries prevention technologies. This study assessed the remineralizing effect of self-assembling peptide (P11-4), Nanosilver Fluoride (NSF) and sodium fluoride (NaF) on white spot lesions (WSLs) in permanent teeth. METHODS Sixty six young adults with WSLs on buccal surfaces in permanent teeth and ICDAS code 1 or 2, were randomly assigned to one of three groups; P11-4, NSF or NaF. Assessment of ICDAS scores, lesion activity (Nyvad scores) and diagnodent readings of lesions were done at baseline and after 1, 3, 6 and 12 months of agents' application. Comparisons between groups were made using chi squared test and comparison within groups were made using McNemar test. Multilevel binary logistic regression was used to assess the effect of agents on change of ICDAS scores after 3, 6 and 12 months (reduction versus no reduction). RESULTS There were 147 teeth in 66 patients; mean ± SD age = 13.46 ± 4.31 years. There were significant differences in the change of ICDAS scores among the three groups after 3 and 6 months (p = 0.005). The reduction in ICDAS score increased steadily in all groups across time with the greatest increase in the P11-4 group: 54.5% after 12 months. Lesion activity (Nyvad scores) showed significant differences among the three groups with the greatest percentage of inactive cases in the P11-4 group. Multilevel binary logistic regression showed non-significant reduction of ICDAS in P11-4 and NSF varnishes compared to NaF varnish (AOR = 2.56, 95% CI: 0.58, 8.77 and AOR = 2.12, 95% CI: 0.59, 7.64 respectively). CONCLUSION P11-4 and NSF varnish reduced the ICDAS scores, caries activity and diagnodent readings of WSLs in permanent teeth. However, the change in ICDAS scores was not significantly different from NaF. TRIAL REGISTRATION This trial was prospectively registered on the clinicaltrials.gov registry with ID: NCT04929509 on 18/6/2021.
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Affiliation(s)
- Sara M Atteya
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, 21527, Alexandria, Egypt.
| | - Hala A Amer
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, 21527, Alexandria, Egypt
| | - Susan M Saleh
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, 21527, Alexandria, Egypt
| | - Yara Safwat
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Carvalho RG, Patekoski LF, Puppin-Rontani RM, Nakaie CR, Nascimento FD, Tersariol ILS. Self-assembled peptide P11-4 interacts with the type I collagen C-terminal telopeptide domain and calcium ions. Dent Mater 2023; 39:708. [PMID: 37394390 DOI: 10.1016/j.dental.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/31/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES Evaluate molecularly the role of P11-4 self-assembly peptide in dentin remineralization and its interaction with collagen I. METHODS The calcium-responsive P11-4 peptide was analyzed by intrinsic fluorescence emission spectrum, circular dichroism spectrum (CD), and atomic force microscope (AFM). Differential light scattering was used to monitor the nucleation growth rate of calcium phosphate nanocrystals in the absence or in the presence of P11-4. AFM was used to analyze the radial size (nm) of calcium phosphate nanocrystals formed in the absence or in the presence of P11-4, as well as to verify the spatial structure of P11-4 in the absence or in the presence of Ca2+. RESULTS The interaction of Ca2+ with the P11-4 (KD = 0.58 ± 0.06 mM) promotes the formation of β-sheet antiparallel structure, leads to its precipitation in saturated solutions of Ca/P = 1.67 and induces the formation of parallel large fibrils (0.6 - 1.5 µm). P11-4 organized the HAP nucleation by reducing both the growth rate and size variability of nanocrystals, analyzed by the F test (p < 0.0001, N = 30). P11-4 interacts (KD = 0.75 ± 0.06 μM) with the KGHRGFSGL motif present at the C-terminal collagen telopeptide domain. P11-4 also increased the amount of HAP and collagen in the MDPC-23 cells. SIGNIFICANCE The presented data propose a mechanism that will help future clinical and/or basic research to better understand a molecule able to inhibit structural collagen loss and help the impaired tissue to remineralize.
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Affiliation(s)
- Rafael Guzella Carvalho
- Department of Biochemistry, Molecular Biology Division, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Luiz Fernando Patekoski
- Department of Biochemistry, Molecular Biology Division, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Regina M Puppin-Rontani
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Clovis Ryuichi Nakaie
- Department of Biophysics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Fabio Dupart Nascimento
- Department of Biochemistry, Molecular Biology Division, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil.
| | - Ivarne L S Tersariol
- Department of Biochemistry, Molecular Biology Division, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil.
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Alkilzy M, Qadri G, Splieth CH, Santamaría RM. Biomimetic Enamel Regeneration Using Self-Assembling Peptide P 11-4. Biomimetics (Basel) 2023; 8:290. [PMID: 37504178 PMCID: PMC10807035 DOI: 10.3390/biomimetics8030290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/15/2023] [Accepted: 07/01/2023] [Indexed: 07/29/2023] Open
Abstract
The recent understanding of the etiology and pathology of dental caries has shifted its treatment from invasive drill and fill conventional strategies to noninvasive and/or minimally invasive approaches. Guided tissue regeneration (GTR) is a well-established therapeutic approach in medicine and periodontal and oral surgery. Recently, the concept of biomimetic regeneration has been further expanded to treat the loss of hard dental tissues. Self-assembling peptides have emerged as a promising biomaterial for biomimetic regeneration due to their ability to construct a protein scaffold in the body of early carious lesions and provide a matrix that promotes remineralization. This review article accompanies the development of self-assembling peptide P11-4 for the treatment of initial carious lesions. In vitro and in vivo studies on the safety, clinical applicability, and efficacy of P11-4 are discussed. Furthermore, different treatment options and potential areas of application are presented.
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Affiliation(s)
- Mohammad Alkilzy
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany
| | - Ghalib Qadri
- Department of Orthodontic and Pediatric Dentistry, Arab American University, Jenin P.O. Box 240, Palestine
| | - Christian H. Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany
| | - Ruth M. Santamaría
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany
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Hafeez S, Aldana AA, Duimel H, Ruiter FAA, Decarli MC, Lapointe V, van Blitterswijk C, Moroni L, Baker MB. Molecular Tuning of a Benzene-1,3,5-Tricarboxamide Supramolecular Fibrous Hydrogel Enables Control over Viscoelasticity and Creates Tunable ECM-Mimetic Hydrogels and Bioinks. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2207053. [PMID: 36858040 DOI: 10.1002/adma.202207053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/13/2023] [Indexed: 06/16/2023]
Abstract
Traditional synthetic covalent hydrogels lack the native tissue dynamics and hierarchical fibrous structure found in the extracellular matrix (ECM). These dynamics and fibrous nanostructures are imperative in obtaining the correct cell/material interactions. Consequently, the challenge to engineer functional dynamics in a fibrous hydrogel and recapitulate native ECM properties remains a bottle-neck to biomimetic hydrogel environments. Here, the molecular tuning of a supramolecular benzene-1,3,5-tricarboxamide (BTA) hydrogelator via simple modulation of hydrophobic substituents is reported. This tuning results in fibrous hydrogels with accessible viscoelasticity over 5 orders of magnitude, while maintaining a constant equilibrium storage modulus. BTA hydrogelators are created with systematic variations in the number of hydrophobic carbon atoms, and this is observed to control the viscoelasticity and stress-relaxation timescales in a logarithmic fashion. Some of these BTA hydrogels are shear-thinning, self-healing, extrudable, and injectable, and can be 3D printed into multiple layers. These hydrogels show high cell viability for chondrocytes and human mesenchymal stem cells, establishing their use in tissue engineering applications. This simple molecular tuning by changing hydrophobicity (with just a few carbon atoms) provides precise control over the viscoelasticity and 3D printability in fibrillar hydrogels and can be ported onto other 1D self-assembling structures. The molecular control and design of hydrogel network dynamics can push the field of supramolecular chemistry toward the design of new ECM-mimicking hydrogelators for numerous cell-culture and tissue-engineering applications and give access toward highly biomimetic bioinks for bioprinting.
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Affiliation(s)
- Shahzad Hafeez
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Ana A Aldana
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Hans Duimel
- Maastricht MultiModal Molecular Imaging (M4I) Institute, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Floor A A Ruiter
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Monize Caiado Decarli
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Vanessa Lapointe
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Clemens van Blitterswijk
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Lorenzo Moroni
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Matthew B Baker
- Department of Complex Tissue Regeneration, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
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Keeper JH, Kibbe LJ, Thakkar-Samtani M, Heaton LJ, Desrosiers C, Vela K, Amaechi BT, Jablonski-Momeni A, Young DA, MacLean J, Weyant RJ, Zandona AF, Sohn W, Pitts N, Frantsve-Hawley J. Systematic review and meta-analysis on the effect of self-assembling peptide P 11-4 on arrest, cavitation, and progression of initial caries lesions. J Am Dent Assoc 2023:S0002-8177(23)00189-7. [PMID: 37245138 DOI: 10.1016/j.adaj.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 02/14/2023] [Accepted: 03/10/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Simple noninvasive evidence-based interventions for caries are needed to overcome limitations in the restorative paradigm. The self-assembling peptide P11-4 is a noninvasive intervention that regenerates enamel in initial caries lesions. STUDIES REVIEWED The authors conducted a systematic review and meta-analysis on the effectiveness of the P11-4 products Curodont Repair (Credentis; now manufactured by vVARDIS) (CR) and Curodont Repair Fluoride Plus (Credentis; now manufactured by vVARDIS) on initial caries lesions. Primary outcomes were lesion progression after 24 months, caries arrest, and cavitation. Secondary outcomes were changes in merged International Caries Detection and Assessment System score categories, quantitative light-induced fluorescence (QLF; Inspektor Research System), esthetic appearance, and lesion size. RESULTS Six clinical trials met the inclusion criteria. Results of this review represent 2 primary and 2 secondary outcomes. When compared with parallel groups, use of CR likely results in a large increase in caries arrest (relative risk [RR], 1.82 [95% CI, 1.32 to 2.50]; 45% attributable risk [95% CI, 24% to 60%]; number needed to treat [NNT], 2.8) and likely decreases lesion size by a mean (SD) of 32% (28%). The evidence also suggests that use of CR results in a large reduction in cavitation (RR, 0.32 [95% CI, 0.10 to 1.06]; NNT, 6.9) and is uncertain about lowering merged International Caries Detection and Assessment System score (RR, 3.68 [95% CI, 0.42 to 32.3]; NNT, 19). No studies used Curodont Repair Fluoride Plus. No studies reported adverse esthetic changes. PRACTICAL IMPLICATIONS CR likely has clinically important effects on caries arrest and decreased lesion size. Two trials had nonmasked assessors, and all trials had elevated risks of bias. The authors recommend conducting longer trials. CR is a promising treatment for initial caries lesions. The protocol for this systematic review was registered a priori with PROSPERO (304794).
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Ligorio C, Mata A. Synthetic extracellular matrices with function-encoding peptides. NATURE REVIEWS BIOENGINEERING 2023; 1:1-19. [PMID: 37359773 PMCID: PMC10127181 DOI: 10.1038/s44222-023-00055-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 06/28/2023]
Abstract
The communication of cells with their surroundings is mostly encoded in the epitopes of structural and signalling proteins present in the extracellular matrix (ECM). These peptide epitopes can be incorporated in biomaterials to serve as function-encoding molecules to modulate cell-cell and cell-ECM interactions. In this Review, we discuss natural and synthetic peptide epitopes as molecular tools to bioengineer bioactive hydrogel materials. We present a library of functional peptide sequences that selectively communicate with cells and the ECM to coordinate biological processes, including epitopes that directly signal to cells, that bind ECM components that subsequently signal to cells, and that regulate ECM turnover. We highlight how these epitopes can be incorporated in different biomaterials as individual or multiple signals, working synergistically or additively. This molecular toolbox can be applied in the design of biomaterials aimed at regulating or controlling cellular and tissue function, repair and regeneration.
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Affiliation(s)
- Cosimo Ligorio
- Biodiscovery Institute, University of Nottingham, Nottingham, UK
- Department of Chemical and Environmental Engineering, University of Nottingham, Nottingham, UK
| | - Alvaro Mata
- Biodiscovery Institute, University of Nottingham, Nottingham, UK
- Department of Chemical and Environmental Engineering, University of Nottingham, Nottingham, UK
- School of Pharmacy, University of Nottingham, Nottingham, UK
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Ghaly YS, El-Wassefy NA, Shamaa MS, Tawfik MA. Effect of self-assembling peptide and other remineralizing agents on preventing initial enamel lesions around orthodontic brackets: An in vitro comparative study. Int Orthod 2023; 21:100751. [PMID: 37003059 DOI: 10.1016/j.ortho.2023.100751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To investigate and compare the effect of self-assembling peptide SAP (P11-4), casein phosphopeptide-amorphous calcium phosphate fluoride paste (CPP-ACPF), and fluoride varnish (FV) on preventing enamel demineralization around orthodontic brackets. MATERIAL AND METHODS Orthodontic brackets were bonded to the buccal surfaces of 80 freshly extracted human maxillary premolars. Teeth were randomly assigned to four groups (n=20) according to the remineralizing agent used as follows: SAP (P11-4) group (Curodont™ Protect/Credentis), CPP-ACPF group (MI Paste Plus®/Recaldent™), fluoride varnish group (Profluoride varnish®/VOCO), and control group. All products were applied according to the manufacturer's instructions. Specimens were cycled in daily refreshed demineralizing and remineralizing solutions for 8h and 16h, respectively, for 28 days. The calcium/phosphorus ratio (Ca/P) and surface microhardness (SMH) were evaluated at baseline and at two and four weeks. Two-way ANOVA (analysis of variance), one-way ANOVA and repeated measures ANOVA were used for statistical analysis. RESULTS Two-way ANOVA demonstrated significant differences between remineralizing agents and time points. After 4 weeks, the SAP (P11-4) group had had significantly higher Ca/P ratio and SMH (1.68±0.11 and 346.47±55.38) compared to other groups, followed by CPP-ACPF (1.52±0.19 and 283.53±64.75), FV (1.37±0.14 and 262.80±82.98), and the control group (1.31±0.10 and 213.00±41.95). Significantly higher Ca/P ratio and SMH were observed at 2 weeks in the control group (1.44±0.10 and 269.63±57.37) and FV group (1.52±0.09 and 321.17±55.24) compared to 4 weeks. No significant differences were found regarding Ca/P ratio and SMH at 2 weeks in the CPP-ACPF (1.55±0.15 and 295.14±53.88) and SAP P11-4 groups (1.64±0.10 and 320.18±58.04) compared to 4 weeks. CONCLUSION SAP (P11-4) had the greatest remineralizing efficacy compared to FV and CPP-ACPF. Moreover, extended period of time improved the preventive efficacy of SAP (P11-4) compared to the other regimens.
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Affiliation(s)
- Yasmin Samir Ghaly
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt.
| | - Noha A El-Wassefy
- Department of Dental Biomaterials, Mansoura University, Faculty of Dentistry, Mansoura, Egypt
| | - Marwa Sameh Shamaa
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt
| | - Marwa Ali Tawfik
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt
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Moras CG, Acharya SR, Adarsh UK, Unnikrishnan VK. Regenerative biomineralization potential of commercially available remineralizing agents as a preventive treatment approach for tooth erosion - An in vitro laser-induced breakdown spectroscopy analysis. J Conserv Dent 2023; 26:165-169. [PMID: 37205890 PMCID: PMC10190084 DOI: 10.4103/jcd.jcd_483_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/12/2022] [Accepted: 11/28/2022] [Indexed: 05/21/2023] Open
Abstract
Context In today's era, erosion is the most prevalent type of tooth wear. The prevention of demineralization with biomineralization is the most desired treatment. Aim The aim of this study is to evaluate and compare the surface remineralization potential of two remineralizing agents - self-assembling peptide P11-4 (SAP P11-4) and calcium silicate plus sodium phosphate (CSSP) salts on intact and demineralized enamel using laser-induced breakdown spectroscopy (LIBS). Subjects and Methods Sixteen maxillary premolars were decoronated and split into buccal and palatal halves embedded in acrylic resin with a total sample size of 32 designated into Group 1 (intact teeth) and Group 2 (demineralized teeth). Further subdivision into Groups 1a and 2a (SAP P11-4 group [n = 8]); Groups 1b and 2b (CSSP group [n = 8]), Group 2 was first exposed to Coca-Cola. Then, all groups were subjected to experimental LIBS. Groups 1a and 2a were treated with SAP P11-4 based product, i.e., CURODONT™ PROTECT gel. Groups 1b and 2b were treated with CSSP-based products regimen, i.e., REGENERATE Enamel Science™ Advanced Toothpaste and Advanced Enamel Serum. The LIBS assessment was redone for all groups to attain a change in Ca and P values. Statistical Analysis Used Inferential statistics were done using Wilcoxon signed-rank test (Before-After product application) and Mann-Whitney U-test (between the groups). Results According to the statistical evaluation there was a statistically significant difference (P < 0.05), in Ca and P values in demineralized teeth when both SAP P11-4 and CSSP groups were evaluated. Although Ca values exhibited a significant difference in intact teeth, P did not exhibit a significant difference on the application of both remineralizing agents. The remineralizing potential between the two agents, SAP P11-4 and CSSP groups. There was no statistically significant difference ( P <0.05) observed between the two agent's remineralization potential for intact and demineralized teeth. Conclusion SAP P11-4 and CSSP have the potential to remineralize both intact and demineralized enamel. There was increased remineralization in demineralized samples subjected to erosion.
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Affiliation(s)
- Carol Gloria Moras
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shashi Rashmi Acharya
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - U. K. Adarsh
- Department of Atomic and Molecular Physics, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - V. K. Unnikrishnan
- Department of Atomic and Molecular Physics, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Centre of Excellence for Biophotonics, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Hardan L, Chedid JCA, Bourgi R, Cuevas-Suárez CE, Lukomska-Szymanska M, Tosco V, Monjarás-Ávila AJ, Jabra M, Salloum-Yared F, Kharouf N, Mancino D, Haikel Y. Peptides in Dentistry: A Scoping Review. Bioengineering (Basel) 2023; 10:bioengineering10020214. [PMID: 36829708 PMCID: PMC9952573 DOI: 10.3390/bioengineering10020214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Currently, it remains unclear which specific peptides could be appropriate for applications in different fields of dentistry. The aim of this scoping review was to scan the contemporary scientific papers related to the types, uses and applications of peptides in dentistry at the moment. Literature database searches were performed in the following databases: PubMed/MEDLINE, Scopus, Web of Science, Embase, and Scielo. A total of 133 articles involving the use of peptides in dentistry-related applications were included. The studies involved experimental designs in animals, microorganisms, or cells; clinical trials were also identified within this review. Most of the applications of peptides included caries management, implant osseointegration, guided tissue regeneration, vital pulp therapy, antimicrobial activity, enamel remineralization, periodontal therapy, the surface modification of tooth implants, and the modification of other restorative materials such as dental adhesives and denture base resins. The in vitro and in vivo studies included in this review suggested that peptides may have beneficial effects for treating early carious lesions, promoting cell adhesion, enhancing the adhesion strength of dental implants, and in tissue engineering as healthy promotors of the periodontium and antimicrobial agents. The lack of clinical trials should be highlighted, leaving a wide space available for the investigation of peptides in dentistry.
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Affiliation(s)
- Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Jean Claude Abou Chedid
- Department of Pediatric Dentistry, Faculty of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
| | - Rim Bourgi
- Department of Restorative Dentistry, School of Dentistry, Saint Joseph University, Beirut 1107 2180, Lebanon
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
| | - Carlos Enrique Cuevas-Suárez
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca 42160, Mexico
- Correspondence: (C.E.C.-S.); (N.K.); (Y.H.); Tel.: +52-(771)-72000 (C.E.C.-S.)
| | | | - Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy
| | - Ana Josefina Monjarás-Ávila
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca 42160, Mexico
| | - Massa Jabra
- Faculty of Medicine, Damascus University, Damascus 0100, Syria
| | | | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000 Strasbourg, France
- Correspondence: (C.E.C.-S.); (N.K.); (Y.H.); Tel.: +52-(771)-72000 (C.E.C.-S.)
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
- Correspondence: (C.E.C.-S.); (N.K.); (Y.H.); Tel.: +52-(771)-72000 (C.E.C.-S.)
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15
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Evaluation of the remineralizing effect of biomimetic self-assembling peptides in post-orthodontic white spot lesions compared to fluoride-based delivery systems: randomized controlled trial. Clin Oral Investig 2023; 27:613-624. [PMID: 36287272 PMCID: PMC9889428 DOI: 10.1007/s00784-022-04757-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/13/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To evaluate the clinical performance of self-assembling peptides versus fluoride-based delivery systems in post-orthodontic white spot lesions. MATERIALS AND METHODS The participants were randomly assigned into two groups (n = 58) according to the remineralizing agent used, where (A) group represented participants receiving a varnish containing 22.600 fluoride ppm and tricalcium phosphate, while the second group (B) represented participants receiving self-assembling peptide. The remineralizing process of the white spot lesion was assessed using the DIAGNOdent pen and ICDAS scoring system according to the time when the remineralizing agent was used (T), where T0 represented the score taken at baseline. T1 represented the score taken after 3 months of follow-ups and T2 score represented the score taken after 6 months of follow-up. Data were collected and statistically analyzed. The parametric data: two-way ANOVA was used to test the effect of interaction among different variables. The non-parametric data: Mann-Whitney test was used. The significance level was set at p ≤ 0.05. RESULTS There was a quantitative statistically significant difference via DIAGNOpen readings between Group A (fluoride material) and Group B (self-assembling peptides). The highest mean value of 10.51 was found in Group A, while the least mean value of 6.45 was found in Group B. Besides, there was a significant difference in each group concerning the time factors T0, T1, and T2 groups where (p < 0.001. As for the qualitative results concerning the ICDAS score, there was no significant difference between the two groups along with the follow-up periods T0, T1, and T2 where the p value is equal to 0.064, 0.087, and 0.277 respectively. CONCLUSIONS The visual assessment using ICDAS reveals that the biomimetic remineralization using self-assembling peptides and the fluoride-based varnish material showed a similar effect in masking post-orthodontic white spot lesions. However, the laser fluorescence using DIAGNOpen showed that the self-assembling peptides reveal higher performance in subsurface remineralization than the fluoride-based varnish material. Therefore, self-assembling peptides are considered a promising material for lesion regression in post-orthodontics white spot lesions. CLINICAL RELEVANCE Self-assembling peptide SAP-14 is a new approach to reverse and mask off post-orthodontics white spot lesions.
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Nanomaterials in Dentistry: Current Applications and Future Scope. NANOMATERIALS 2022; 12:nano12101676. [PMID: 35630898 PMCID: PMC9144694 DOI: 10.3390/nano12101676] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 02/06/2023]
Abstract
Nanotechnology utilizes the mechanics to control the size and morphology of the particles in the required nano range for accomplishing the intended purposes. There was a time when it was predominantly applied only to the fields of matter physics or chemical engineering, but with time, biological scientists recognized its vast benefits and explored the advantages in their respective fields. This extension of nanotechnology in the field of dentistry is termed ‘Nanodentistry.’ It is revolutionizing every aspect of dentistry. It consists of therapeutic and diagnostic tools and supportive aids to maintain oral hygiene with the help of nanomaterials. Research in nanodentistry is evolving holistically but slowly with the advanced finding of symbiotic use of novel polymers, natural polymers, metals, minerals, and drugs. These materials, in association with nanotechnology, further assist in exploring the usage of nano dental adducts in prosthodontic, regeneration, orthodontic, etc. Moreover, drug release cargo abilities of the nano dental adduct provide an extra edge to dentistry over their conventional counterparts. Nano dentistry has expanded to every single branch of dentistry. In the present review, we will present a holistic view of the recent advances in the field of nanodentistry. The later part of the review compiled the ethical and regulatory challenges in the commercialization of the nanodentistry. This review tracks the advancement in nano dentistry in different but important domains of dentistry.
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Daneshmandi L, Holt BD, Arnold AM, Laurencin CT, Sydlik SA. Ultra-low binder content 3D printed calcium phosphate graphene scaffolds as resorbable, osteoinductive matrices that support bone formation in vivo. Sci Rep 2022; 12:6960. [PMID: 35484292 PMCID: PMC9050648 DOI: 10.1038/s41598-022-10603-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/02/2022] [Indexed: 12/18/2022] Open
Abstract
Bone regenerative engineering could replace autografts; however, no synthetic material fulfills all design criteria. Nanocarbons incorporated into three-dimensional printed (3DP) matrices can improve properties, but incorporation is constrained to low wt%. Further, unmodified nanocarbons have limited osteogenic potential. Functionalization to calcium phosphate graphene (CaPG) imparts osteoinductivity and osteoconductivity, but loading into matrices remained limited. This work presents ultra-high content (90%), 3DP-CaPG matrices. 3DP-CaPG matrices are highly porous (95%), moderately stiff (3 MPa), and mechanically robust. In vitro, they are cytocompatible and induce osteogenic differentiation of human mesenchymal stem cells (hMSCs), indicated by alkaline phosphatase, mineralization, and COL1α1 expression. In vivo, bone regeneration was studied using a transgenic fluorescent-reporter mouse non-union calvarial defect model. 3DP-CaPG stimulates cellular ingrowth, retains donor cells, and induces osteogenic differentiation. Histology shows TRAP staining around struts, suggesting potential osteoclast activity. Apparent resorption of 3DP-CaPG was observed and presented no toxicity. 3DP-CaPG represents an advancement towards a synthetic bone regeneration matrix.
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Affiliation(s)
- Leila Daneshmandi
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT, 06030, USA
- Raymond and Beverly Sackler Center for Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT, 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Department of Orthopaedic Surgery, UConn Health, Farmington, CT, 06030, USA
| | - Brian D Holt
- Department of Chemistry, Carnegie Mellon University, 4400 Fifth Avenue, Pittsburgh, PA, 15213, USA
| | - Anne M Arnold
- Department of Chemistry, Carnegie Mellon University, 4400 Fifth Avenue, Pittsburgh, PA, 15213, USA
- National Security Directorate, Pacific Northwest National Laboratory, Richland, WA, 99354, USA
| | - Cato T Laurencin
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT, 06030, USA.
- Raymond and Beverly Sackler Center for Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT, 06030, USA.
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA.
- Department of Orthopaedic Surgery, UConn Health, Farmington, CT, 06030, USA.
- Department of Material Science and Engineering, University of Connecticut, Storrs, CT, 06269, USA.
- Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT, 06269, USA.
| | - Stefanie A Sydlik
- Department of Chemistry, Carnegie Mellon University, 4400 Fifth Avenue, Pittsburgh, PA, 15213, USA.
- Department of Biomedical Engineering, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA, 15213, USA.
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Hojabri N, Kunzelmann KH. Adhesion and whitening efficacy of P11-4 self-assembling peptide and HAP suspension after using NaOCl as a pre-treatment agent. BMC Oral Health 2022; 22:59. [PMID: 35246089 PMCID: PMC8895591 DOI: 10.1186/s12903-022-02080-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background This study evaluated the adhesion and whitening efficacy of a mixture of hydroxyapatite and P11-4 self-assembling peptide (HAP-peptide) on bovine enamel after pre-treatment with low-concentrated sodium hypochlorite (NaOCl). Methods Fifty-two caries-free bovine incisors were selected. 50 teeth were randomly allocated to five groups (n = 10). The first group was treated with a mixture of 6.25 wt% HAP and 5 ml P11-4 peptide, using NaOCl 3% as pre-treatment. Second, third and fourth groups were treated with 6.25 wt% HAP, 5 ml P11-4 peptide, and NaOCl 3%, respectively. In the fifth group, only water was applied (control group). The color of samples was measured using a spectrophotometer (USB4000-VIS-NIR-ES, Ostfildern, Germany). To evaluate color changes, ΔE values were statistically analyzed. Finally, adherence of HAP particles on two enamel surfaces with and without pre-treatment with NaOCl was analyzed with SEM. Results It was observed that the ΔE of the HAP-peptide suspension after pre-treatment with NaOCl was significantly stronger than the control group. In contrast, the overall color changes of separate applications of HAP, peptide, and NaOCl did not differ notably from the control group. SEM observations confirmed that pre-treatment with NaOCl resulted in a more pronounced coverage of HAP on the enamel surface. Conclusions Pre-treatment with a low-concentrated NaOCl enhanced the adherence of the HAP layer on the enamel surface, resulting in a stronger whitening effect. Trial registration The peptide-HAP suspension is effective in improving tooth whiteness.
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Affiliation(s)
- Niloofar Hojabri
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - Karl-Heinz Kunzelmann
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany.
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B K A, R Y, Puranik MP. Remineralizsation of early enamel caries lesions using self-assembling peptides P11-4: Systematic review and meta-analysis. J Oral Biol Craniofac Res 2022; 12:324-331. [DOI: 10.1016/j.jobcr.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/19/2022] [Indexed: 10/18/2022] Open
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Effectiveness of Self-Assembling Peptide (P11-4) in Dental Hard Tissue Conditions: A Comprehensive Review. Polymers (Basel) 2022; 14:polym14040792. [PMID: 35215706 PMCID: PMC8879648 DOI: 10.3390/polym14040792] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/13/2022] [Accepted: 02/16/2022] [Indexed: 12/04/2022] Open
Abstract
The limitations on the use of fluoride therapy in dental caries prevention has necessitated the development of newer preventive agents. This review focusses on the recent and significant studies on P11-4 peptide with an emphasis on different applications in dental hard tissue conditions. The self-assembling peptide P11-4 diffuses into the subsurface lesion assembles into aggregates throughout the lesion, supporting the nucleation of de novo hydroxyapatite nanocrystals, resulting in increased mineral density. P11-4 treated teeth shows more remarkable changes in the lesion area between the first and second weeks. The biomimetic remineralisation facilitated in conjunction with fluoride application is an effective and non-invasive treatment for early carious lesions. Despite, some studies have reported that the P11-4 group had the least amount of remineralised enamel microhardness and a significantly lower mean calcium/phosphate weight percentage ratio than the others. In addition, when compared to a low-viscosity resin, self-assembling peptides could neither inhibit nor mask the lesions significantly. Moreover, when it is combined with other agents, better results can be achieved, allowing more effective biomimetic remineralisation. Other applications discussed include treatment of dental erosion, tooth whitening and dentinal caries. However, the evidence on its true clinical potential in varied dental diseases still remains under-explored, which calls for future cohort studies on its in vivo efficacy.
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Memarpour M, Razmjouei F, Rafiee A, Vossoughi M. Remineralization effects of self-assembling peptide P 11 -4 associated with three materials on early enamel carious lesions: An in vitro study. Microsc Res Tech 2022; 85:630-640. [PMID: 34549853 DOI: 10.1002/jemt.23937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/28/2021] [Accepted: 09/01/2021] [Indexed: 11/09/2022]
Abstract
The aim of this study was to assess the remineralization of enamel caries lesions using the self-assembling peptide P11 -4 associated with different materials. Artificial early enamel lesions were prepared on 154 primary teeth. The samples were randomly divided into eight groups: (1) control, (2) P11 -4, (3) fluoridate toothpaste (FT), (4) P11 -4 + FT, (5) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), (6) P11 -4 + CPP-ACP, (7) fluoridate bioactive glass toothpaste (BT), and (8) P11 -4 + BT. The surface enamel microhardness (EMH) and energy-dispersive X-ray spectroscopy (EDS) of the teeth were then measured at the baseline, after demineralization, and after 28 days of remineralization. The enamel surfaces were assessed by field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM). The data were analyzed with one-way analysis of variance (ANOVA) (p < .05). EMH after demineralization was significantly lower than the baseline value (p < .001). The interventions led to an enhanced percentage of EMH recovery (%REMH), which was higher in Groups 6 and 7. There was no significant difference between Groups 3 and 4. Groups 1 and 2 had the lowest %REMH. The mean calcium/phosphate weight percentage ratio of P11 -4 was significantly lower than the others (p < .001). The FESEM and AFM images revealed mineral deposition on the eroded enamel and reductions in surface roughness in Groups 5 and 7.
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Affiliation(s)
- Mahtab Memarpour
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faranak Razmjouei
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azade Rafiee
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Vossoughi
- Oral and Dental Disease Research Center, Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Wahba N, Schwendicke F, Kamel MA, Allam G, Kabil N, Elhennawy K. Preventing and Arresting Primary Tooth Enamel Lesions Using Self- Assembling Peptide P 11-4 In Vitro. J Int Soc Prev Community Dent 2022; 12:58-70. [PMID: 35281691 PMCID: PMC8896585 DOI: 10.4103/jispcd.jispcd_257_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 11/04/2022] Open
Abstract
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% × µm) and FMW (-33.35 [124.65] vol% × µm) 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% × µm) and FV (median = 6076.05 [5190.08] vol% × µm) 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.
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Affiliation(s)
- Nour Wahba
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité – Universitätsmedizin Berlin, Germany,Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt,Address for correspondence: Mrs. Nour Wahba, Pediatric Dentistry Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St, El-Qobba Bridge, Al Waili, Cairo Governorate, Egypt. E-mail:
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité – Universitätsmedizin Berlin, Germany
| | - Mohamed A Kamel
- Department of Operative Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Gehan Allam
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt,Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - Noha Kabil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo, Egypt,Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - Karim Elhennawy
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité – Universitätsmedizin Berlin, Germany
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Özdemir Ş, Taran PK, Mammadlı N, Altınova İS, Gazioğlu I. Remineralization potential of P11-4 and fluoride on secondary carious primary enamel: A quantitative evaluation using microcomputed tomography. Microsc Res Tech 2022; 85:807-812. [PMID: 34981866 DOI: 10.1002/jemt.24052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/16/2021] [Accepted: 12/26/2021] [Indexed: 11/09/2022]
Abstract
The aim of this study was to assess the ability of self-assembling peptide (P11-4) diffusion, assembly, and remineralization to effect artificial secondary caries-like lesions in human primary teeth in vitro. Enamel-dentin blocks obtained from extracted human primary molars were embedded into epoxy resin blocks. Cavities (approximately 1 × 1 × 2 mm) were prepared on the surface using a high-speed diamond bur under constant water cooling and filled with composite restorative material (Filtek Z250; 3 M ESPE). The samples were immersed in demineralizing solution (20 ml) for 96 h to produce secondary caries lesions and divided into two groups according to the testing materials: fluoride varnish (Duraphat; Colgate, UK) and P11-4 (Curodont Repair; Credentis, Switzerland). Except for the control areas, all samples were remineralized for 3-5 min using the remineralizing agents, and then all the sections were placed in a pH-cycling system for 5 days at 35°C. The pH cycling procedure was followed by micro-CT analysis for the qualitative evaluation of surface changes. The Mann-Whitney U test was used to compare two independent groups. In the comparison of more than two dependent groups, Bonferroni smoothed pairwise analyses were used to determine the source of the Kruskal-Wallis H test difference. The results of the study revealed that the remineralization depths of the peptide group were higher than those of the fluoride group (p < .01). There was a statistically significant difference in remineralization effects between the fluoride and peptide groups. P11-4 can be considered as an effective remineralizing agent for secondary caries lesions.
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Affiliation(s)
- Şerife Özdemir
- Department of Pediatric Dentistry, Bezmialem Vakif University Faculty of Dentistry, Istanbul, Turkey
| | - Pınar Kınay Taran
- Department of Pediatric Dentistry, Bezmialem Vakif University Faculty of Dentistry, Istanbul, Turkey
| | - Narmin Mammadlı
- Department of Pediatric Dentistry, Bezmialem Vakif University Faculty of Dentistry, Istanbul, Turkey
| | - İlay Sena Altınova
- Department of Pediatric Dentistry, Bezmialem Vakif University Faculty of Dentistry, Istanbul, Turkey
| | - Işıl Gazioğlu
- Department of Basic Pharmaceutical Sciences, Bezmialem Vakif University Faculty of Pharmacy, Istanbul, Turkey
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Tang S, Dong Z, Ke X, Luo J, Li J. Advances in biomineralization-inspired materials for hard tissue repair. Int J Oral Sci 2021; 13:42. [PMID: 34876550 PMCID: PMC8651686 DOI: 10.1038/s41368-021-00147-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022] Open
Abstract
Biomineralization is the process by which organisms form mineralized tissues with hierarchical structures and excellent properties, including the bones and teeth in vertebrates. The underlying mechanisms and pathways of biomineralization provide inspiration for designing and constructing materials to repair hard tissues. In particular, the formation processes of minerals can be partly replicated by utilizing bioinspired artificial materials to mimic the functions of biomolecules or stabilize intermediate mineral phases involved in biomineralization. Here, we review recent advances in biomineralization-inspired materials developed for hard tissue repair. Biomineralization-inspired materials are categorized into different types based on their specific applications, which include bone repair, dentin remineralization, and enamel remineralization. Finally, the advantages and limitations of these materials are summarized, and several perspectives on future directions are discussed.
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Affiliation(s)
- Shuxian Tang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, PR China
| | - Zhiyun Dong
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, PR China
| | - Xiang Ke
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, PR China
| | - Jun Luo
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, PR China.
| | - Jianshu Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, PR China.
- Med-X Center for Materials, Sichuan University, Chengdu, PR China.
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25
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Cell-Free Biomimetic Mineralization Strategies to Regenerate the Enamel Microstructure. CRYSTALS 2021. [DOI: 10.3390/cryst11111385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The distinct architecture of native enamel gives it its exquisite appearance and excellent intrinsic-extrinsic fracture toughening properties. However, damage to the enamel is irreversible. At present, the clinical treatment for enamel lesion is an invasive method; besides, its limitations, caused by the chemical and physical difference between restorative materials and dental hard tissue, makes the restorative effects far from ideal. With more investigations on the mechanism of amelogenesis, biomimetic mineralization techniques for enamel regeneration have been well developed, which hold great promise as a non-invasive strategy for enamel restoration. This review disclosed the chemical and physical mechanism of amelogenesis; meanwhile, it overviewed and summarized studies involving the regeneration of enamel microstructure in cell-free biomineralization approaches, which could bring new prospects for resolving the challenges in enamel regeneration.
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Grohe B, Mittler S. Advanced non-fluoride approaches to dental enamel remineralization: The next level in enamel repair management. BIOMATERIALS AND BIOSYSTEMS 2021; 4:100029. [PMID: 36824571 PMCID: PMC9934497 DOI: 10.1016/j.bbiosy.2021.100029] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/22/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022] Open
Abstract
In modern dentistry, a minimally invasive management of early caries lesions or early-stage erosive tooth wear (ETW) with synthetic remineralization systems has become indispensable. In addition to fluoride, which is still the non-plus-ultra in these early caries/ETW treatments, a number of new developments are in the test phase or have already been commercialized. Some of these systems claim that they are comparable or even superior to fluoride in terms of their ability to remineralize enamel. Besides, their use can help avoid some of the risks associated with fluoride and support treatments of patients with a high risk of caries. Two individual non-fluoride systems can be distinguished; intrinsic and extrinsic remineralization approaches. Intrinsic (protein/peptide) systems adsorb to hydroxyapatite crystals/organics located within enamel prisms and accumulate endogenous calcium and phosphate ions from saliva, which ultimately leads to the re-growth of enamel crystals. Extrinsic remineralization systems function on the basis of the external (non-saliva) supply of calcium and phosphate to the crystals to be re-grown. This article, following an introduction into enamel (re)mineralization and fluoride-assisted remineralization, discusses the requirements for non-fluoride remineralization systems, particularly their mechanisms and challenges, and summarizes the findings that underpin the most promising advances in enamel remineralization therapy.
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Affiliation(s)
- Bernd Grohe
- Lawson Health Research Institute, St. Joseph's Hospital, London, ON, N6A 4V2 Canada,Corresponding author at: 268 Grosvenor Street, London, ON, N6A 4V2, Canada.
| | - Silvia Mittler
- Department of Physics & Astronomy, University of Western Ontario, London, ON, N6A 3K7 Canada,Department of Chemical and Biochemical Engineering, University of Western Ontario, London, ON, N6A 5B9 Canada
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Hojabri N, Kaisarly D, Kunzelmann KH. Adhesion and whitening effects of P11-4 self-assembling peptide and HAP suspension on bovine enamel. Clin Oral Investig 2021; 25:3237-3247. [PMID: 33108484 PMCID: PMC8060195 DOI: 10.1007/s00784-020-03654-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/20/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study evaluated the adhesion and whitening effects of a combination of P11-4 self-assembling peptide and hydroxyapatite (peptide-HAP) on bovine enamel. METHODS Forty-six caries-free bovine teeth were selected, and 40 teeth were randomly allocated to one of five groups (n = 8). First, the effects of application frequency, exposure time, and storage in saliva on the whitening effects of an experimental low-concentrated peptide-HAP suspension (0.5 wt% HAP; Curodont, Credentis) were evaluated and compared with a commercial bleaching agent (VivaStyle Paint on Plus, VS, Ivoclar Vivadent). Tooth color was measured using a spectrophotometer (Gretag MacBeth), and color changes ΔE were statistically analyzed. Second, the effects of peptide-HAP concentration (low versus high: 6.25% HAP; Curodont Protect), and its interactions with saliva and postapplication restaining, were investigated. Third, enamel surfaces (n = 2) were treated with low concentration peptide-HAP and high-concentration peptide-HAP in polymeric and monomeric forms (Curodont Protect & Curodont Repair, Credentis) and analyzed by SEM. RESULTS The ΔE of the low-concentration peptide-HAP suspension did not differ from that of VS. Application frequency, exposure time, and storage in saliva did not have any significant impact on whitening efficacy of the peptide-HAP suspension. Increasing the concentration of the suspension did not promote overall ΔE. SEM observations confirmed the presence of the newly generated peptide and HAP on the enamel surface. CONCLUSIONS The peptide-HAP suspension is a mild tooth whitener, and the adhesion of peptide-HAP to enamel is concentration dependent. CLINICAL RELEVANCE This peptide-HAP suspension is effective in offsetting discoloration caused by restaining after treatment.
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Affiliation(s)
- Niloofar Hojabri
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - Dalia Kaisarly
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany.
- Biomaterials Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
| | - Karl-Heinz Kunzelmann
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
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Bilge K, Kılıç V. Effects of different remineralizing agents on color stability and surface characteristics of the teeth following vital bleaching. Microsc Res Tech 2021; 84:2206-2218. [PMID: 33852758 DOI: 10.1002/jemt.23774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 11/06/2022]
Abstract
The aim of the study was to investigate the effects of various remineralizing agents on the color stability and surface characteristics of the teeth after vital bleaching. The extracted 96 human incisors were used for the study. Initially, the samples were randomly divided into two groups and exposed to in-office and at-home bleaching agents. Then, the groups were divided into six subgroups (n = 8), including the control group did not undergo remineralization after bleaching, according to five remineralizing agents (Gelato APF Gel, Remin Pro, Tooth Mousse, MI Paste Plus, Curodont Protect). Surface roughness was assessed at baseline, after bleaching and remineralization procedures. Color measurements of the samples were obtained at baseline, after bleaching and then after immersion in the staining solution following remineralization process. Scanning electron microscopy and atomic force microscopy (AFM) analyzes were carried out in order to examine the morphological changes on the surface of the enamel. The independent t-test, paired-samples t-test, and one-way ANOVA was used to compare the data and post-hoc LSD test to compare the difference among the study groups (α = .05). Surface roughness increased following in-office and at-home bleaching in all groups, and reduced after application of remineralizing agents in all groups. Significant differences were found among the groups with respect to changes in surface roughness and color values following treatment with remineralizing agents (p <.05). AFM analyses revealed increased surface roughness after bleaching and a reduction of rough surfaces following treatment with remineralizing agents. Remineralizing agents can be used to reduce postbleaching increase in surface roughness and to maintain color stability after bleaching.
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Affiliation(s)
- Kübra Bilge
- Department of Restorative Dentistry, Faculty of Dentistry, Firat University, Elazig, Turkey
| | - Vahti Kılıç
- Department of Restorative Dentistry, Faculty of Dentistry, Firat University, Elazig, Turkey
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Wierichs RJ, Carvalho TS, Wolf TG. Efficacy of a self-assembling peptide to remineralize initial caries lesions - A systematic review and meta-analysis. J Dent 2021; 109:103652. [PMID: 33798639 DOI: 10.1016/j.jdent.2021.103652] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/25/2021] [Accepted: 03/27/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION/OBJECTIVES The present review systematically analyzed clinical studies investigating the efficacy of self-assembling peptides (SAP) to reduce initiation of or to remineralize initial caries lesions. DATA Prospective controlled (non-)randomized clinical trials investigating the efficacy of a self-assembling peptide compared to any other (placebo) treatment or untreated/standard control. Outcomes were visual analog scale (VAS), laser fluorescence, ICDAS score or morphometric measurements. SOURCES Three electronic databases (Central, PubMed, Ovid EMBASE) were screened. No language or time restrictions were applied.. Risk of Bias and level of evidence was graded using Risk of Bias 2.0 tool and Grade Profiler 3.6. STUDY SELECTION/RESULTS Seven studies with 508 teeth being affected in 294 patients were included. All studies were randomized controlled trials (RCT), five with a split-mouth and two with a parallel-arm design. Meta-analysis could be performed for SAP (plus fluoride varnish (FV)) vs. no treatment (plus FV) (control treatment). Depending on the outcome after up to 12 months SAP showed a significantly higher optical improvement than the control treatment (laser fluorescence: Standardized Mean Difference (SMD)[95 %CI] = -0.87[-1.39,-0.34; VAS: Mean Difference (MD)[95 %CI] = -35.38[-43.13,-27.64]) or no significant difference could be observed (ICDAS/activity score; Relative Risk (RR)[95 %CI] = 0.6[0.21,1.74]; morphometric measurements: SMD[95 %CI] = -1.95[-4.54,0.65]). Level of evidence was very low for all 4 outcomes. Furthermore, six studies showed a high risk of bias and six studies were (partially) funded by the manufactures of the tested products. CONCLUSION Based on a low number of clinical trials with relatively short follow up-periods and high risks of bias, self-assembling peptides may be a viable option to remineralize enamel caries. CLINICAL SIGNIFICANCE Self-assembling peptides may be a viable option to remineralize enamel caries. However, results should be interpretated with caution due the low number of clinical trials, the short follow-up periods and the limiting grade of evidence.
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Affiliation(s)
- R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland.
| | - T S Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland
| | - T G Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland
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Mohamed RN, Basha S, Al-Thomali Y, Saleh Alshamrani A, Salem Alzahrani F, Tawfik Enan E. Self-assembling peptide P 11-4 in remineralization of enamel caries - a systematic review of in-vitro studies. Acta Odontol Scand 2021; 79:139-146. [PMID: 33026894 DOI: 10.1080/00016357.2020.1825799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The present systematic review was conducted to investigate the effect of the self-assembling peptide (SAP) - P11-4 in the remineralization of enamel caries. MATERIAL AND METHODS The systematic search for studies was conducted through CINAHL, EMBASE, MEDLINE, Scopus, PsychINFO, and various key journals. This review was conducted in adherence to PRISMA standards and was registered in PROSPERO with registration number CRD42019110156. The methodological quality of the studies was graded through Cochrane's tool of risk of bias in non-randomized studies - of interventions (ROBINS-I). RESULTS In total, 91 studies were identified for screening, and 12 studies were eligible. Ten studies showed effective enamel remineralization with P11-4 compared to controls. One study showed a combination of P11-4 with fluoride varnish or Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CPP-ACPF) leads to significantly higher remineralization compared to P11-4 alone. Quality assessment of study showed 6 (50%) studies as medium risk of bias and 6 (50%) studies as low risk of bias. CONCLUSION To conclude, the present study results showed SAP- P11-4 is effective in the remineralization of enamel caries.
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Affiliation(s)
- Roshan Noor Mohamed
- Department of Pedodontics, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Sakeenabi Basha
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Yousef Al-Thomali
- Department of Orthodontics, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Ammar Saleh Alshamrani
- Department of Pedodontics, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
- Department of Restorative Dentistry, Taif University, Taif, Saudi Arabia
| | - Fatma Salem Alzahrani
- Department of Pedodontics, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Enas Tawfik Enan
- Department of Dental Biomaterials, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
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Kobeissi R, Badr SB, Osman E. Effectiveness of Self-assembling Peptide P 11-4 Compared to Tricalcium Phosphate Fluoride Varnish in Remineralization of White Spot Lesions: A Clinical Randomized Trial. Int J Clin Pediatr Dent 2021; 13:451-456. [PMID: 33623327 PMCID: PMC7887159 DOI: 10.5005/jp-journals-10005-1804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Fluoride varnish with therapeutic tricalcium phosphate formulas such as Clinpro™ varnish has shown greater tendency in treating white spot lesions (WSLs) by inhibiting the progression of initial enamel lesions through the mineral exchange. The self-assembling peptide SAP11-4 (Curodont Repair, CDR) works on a different scale in treating WSLs by mimicking the enamel matrix and aiming to guided enamel regeneration. Aim To quantitatively and qualitatively compare the effectiveness of the SAP11-4 vs tricalcium posphate fluoride (TCPF) in remineralization of WSLs in young permanent teeth. Materials and methods Nine healthy patients were enrolled in this study. The trial was performed on 40 young permanent teeth in the initial demineralization stage. Teeth were randomly assigned to receive either TCPF (group I) or SAP11-4 (group II). Lesions were assessed at pretreatment, 3, and 6 months posttreatment quantitatively per laser fluorescence DIAGNOdent pen and qualitatively through the International Caries Detection and Assessment System (ICDAS) II. Results The result of the current study revealed a significant quantitative and qualitative increase in remineralization of WSLs in both groups and over time intervals. However, the WSL recovery was significantly better in the self-assembling peptide group, reflecting an excellent remineralization potential of the WSLs by the SAP11-4 compared to TCPF varnish. Conclusion Both TCPF and SAP11-4 were effective in treating WSLs. However, the success of guided enamel regeneration by the SAP11-4 through the biomineralization has proven superiority of this material compared to TCPF. Clinical significance Early detection of WSLs and minimal intervention through remineralizing agents can limit unnecessary tissue loss, further caries progression, and consequently prevent further harm to the patients. How to cite this article Kobeissi R, Badr SBY, Osman E. Effectiveness of Self-assembling Peptide P11-4 Compared to Tricalcium Phosphate Fluoride Varnish in remineralization of White Spot Lesions: A Clinical Randomized Trial. Int J Clin Pediatr Dent 2020;13(5):451-456.
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Affiliation(s)
- Riham Kobeissi
- Department of Pediatric Dentistry, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Sherine By Badr
- Department of Pediatric Dentistry and Dental Public Health, Cairo University, Giza, Egypt
| | - Essam Osman
- Department of Restorative Sciences, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
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Moreira KM, Bertassoni LE, Davies RP, Joia F, Höfling JF, Nascimento FD, Puppin-Rontani RM. Impact of biomineralization on resin/biomineralized dentin bond longevity in a minimally invasive approach: An "in vitro" 18-month follow-up. Dent Mater 2021; 37:e276-e289. [PMID: 33608139 DOI: 10.1016/j.dental.2021.01.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To determine the impact of treating caries-affected dentin (CAD) with: 0.2% sodium fluoride (NaF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP/MI Paste™) or peptide P11-4 (Curodont™ Repair) on the longevity of resin/CAD interface at storage times of 24 -h, 6- and 18-month. METHODS 255 caries-free third molars were used, and CAD was produced by a biological method. The teeth were randomly distributed into: G1- Sound dentin (SD); G2- CAD; G3- CAD + 0.2% NaF (CAD/NaF); G4- CAD + CPP-ACP (CAD/ACP); G5- CAD + Curodont™ Repair (CAD/P11-4). The Filtek Z350 composite resin block was bonded to dentin using Adper™ Single 2 (4 mm/height). Resin/dentin blocks were stored in a solution of Simulated Body Fluid at 37 °C, pressures were modified to simulate natural pulpal pressures. Specimens were investigated by microtensile bond strength (μTBS) (n = 8), Scanning Electron Microscopy (to assess the failure mode) (n = 8), nanoinfiltration (to assess the interface sealing) (n = 3), in situ zymography (to assess the gelatinolytic activity) (n = 3) and micro-computed microtomography (μ-CT) (to assess the mineralization) (n = 3). Data from μTBS, μ-CT and, nanoinfiltration and hybrid layer formation/degradation were submitted to two-way ANOVA and Tukey tests, and failure patterns and in situ zymography to Kruskal-Wallis and Dunn tests (α = 5%). RESULTS The highest mineral density change by μ-CT, smallest silver nitrate infiltration and proteolytic activity in the adhesive layer were obtained significantly for the groups SD, CAD/ACP and CAD/P11-4, with most mixed fractures at 18-month (p < 0.001). CAD/NaF showed significantly similar values to CAD, CAD and CAD/NaF which presented a high percentage of adhesive fracture (p < 0.001) at all time periods. SIGNIFICANCE Treating caries-affected dentin with remineralizing agents CPP-ACP and Curodont™ Repair, has the potential to be a clinically relevant treatment protocol to increase the longevity of adhesive restorations.
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Affiliation(s)
- Kelly Maria Moreira
- Department of Science Health and Pediatric Dentistry, Division of Pediatric Dentistry, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba 13414-903, SP, Brazil.
| | - Luiz Eduardo Bertassoni
- Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, Oregon Health and Science University, Portland, OR 97201, USA.
| | - Robert Phill Davies
- Division of Oral Biology, School of Dentistry, Faculty of Medicine & Health, University of Leeds, Leeds S9 7TF, UK.
| | - Felipe Joia
- Department of Oral Diagnosis, Piracicaba Dental School University of Campinas - UNICAMP, Piracicaba 13414-903, SP, Brazil.
| | - José Francisco Höfling
- Department of Oral Diagnosis, Piracicaba Dental School University of Campinas - UNICAMP, Piracicaba 13414-903, SP, Brazil.
| | - Fabio Duprat Nascimento
- Interdisciplinary Center of Biochemistry Investigation, University of Mogi das Cruzes, Mogi das Cruzes 08780-911, SP, Brazil.
| | - Regina Maria Puppin-Rontani
- Department of Science Health and Pediatric Dentistry, Division of Pediatric Dentistry, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba 13414-903, SP, Brazil.
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Gelain F, Luo Z, Rioult M, Zhang S. Self-assembling peptide scaffolds in the clinic. NPJ Regen Med 2021; 6:9. [PMID: 33597509 PMCID: PMC7889856 DOI: 10.1038/s41536-020-00116-w] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 12/03/2020] [Indexed: 12/11/2022] Open
Abstract
Well-defined scaffold hydrogels made of self-assembling peptides have found their way into clinical products. By examining the properties and applications of two self-assembling peptides-EAK16 and RADA16-we highlight the potential for translating designer biological scaffolds into commercial products.
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Affiliation(s)
- Fabrizio Gelain
- Institute for Stem-Cell Biology, Regenerative Medicine and Innovative Therapies (ISBREMIT), IRCCS Casa Sollievo della Sofferenza, 71013, San Giovanni Rotondo, Italy.
- Center for Nanomedicine and Tissue Engineering (CNTE), ASST Grande Ospedale Metropolitano Niguarda, 20162, Milan, Italy.
| | - Zhongli Luo
- College of Basic Medical Sciences, Molecular Medicine and Cancer Research Centre, Chongqing Medical University, Chongqing, 400016, China.
| | | | - Shuguang Zhang
- Laboratory of Molecular Architecture, Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139-4307, USA.
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Lena Sezici Y, Yetkiner E, Aykut Yetkiner A, Eden E, Attin R. Comparative evaluation of fluoride varnishes, self-assembling peptide-based remineralization agent, and enamel matrix protein derivative on artificial enamel remineralization in vitro. Prog Orthod 2021; 22:4. [PMID: 33491110 PMCID: PMC7829296 DOI: 10.1186/s40510-020-00345-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 12/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background One of the most unfavorable side effects of fixed orthodontic treatment is white spot lesions (WSLs). Although the most important approach is prevention of WSLs, it is also essential to evaluate the efficacy of the remineralization agents. However, there is no concurrence in the literature with respect to the remineralization process of these agents. The objective of the present study was to evaluate the effects of different fluoride varnishes, enamel matrix protein, and self-assembling peptide derivatives with varying chemical compositions on remineralization of artificially created WSLs in vitro using quantitative light-induced fluorescence (QLF). Methods Artificial WSLs were created on bovine enamel samples using acidic buffer solution (pH 5, 10 days). Specimens were randomly allocated to six groups (n = 10/group): (1) Emdogain (Straumann, Basel, Switzerland), (2) Curodont Repair (Credentis AG, Switzerland), (3) Duraphat (Colgate-Palmolive, New York, NY), (4) Clinpro XT (3 M ESPE, Pymble, New South Wales, Australia), (5) Enamel Pro Varnish (Premier Dental Products, PA, USA), and (6) control (untreated). The agents were applied to the WSLs according to the manufacturers’ instructions. Fluorescence loss (ΔF), lesion area (area), and impact (ΔQ) values of enamel surfaces were quantified by QLF-D BiluminatorTM (Inspektor-Pro, Amsterdam, The Netherlands) at baseline and after 7, 14, and 21 days of application of the respective materials. Results ΔF value presented a significantly decreasing trend throughout the 21 days for all groups except the Duraphat and Enamel Pro varnishes. The changes between 14th and 21st days of the Clinpro XT varnish application were significantly higher than Emdogain, Curodont, and Enamel Pro. The Curodont group showed higher lesion area changes between the first and second week in comparison to the Emdogain, Clinpro XT, and Enamel Pro groups, whereas Clinpro XT assured the highest reduction from the second to the third week of the observation period. Conclusions The fluorescence loss was significantly reduced with enamel matrix protein, self-assembling peptide, and light-curable fluoride varnishes in the analysis for 21 days. Curodont and Clinpro XT were effective in diminishing the fluorescence loss and lesion area compared to the Duraphat, Enamel Pro fluoride varnishes, and Emdogain in different time points.
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Affiliation(s)
| | - Enver Yetkiner
- Department of Orthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Arzu Aykut Yetkiner
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey.
| | - Ece Eden
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Rengin Attin
- Clinic for Orthodontics and Pediatric Dentistry, University of Zurich, Zurich, Switzerland
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Abstract
Self-assembly of proteins and peptides into the amyloid fold is a widespread phenomenon in the natural world. The structural hallmark of self-assembly into amyloid fibrillar assemblies is the cross-beta motif, which conveys distinct morphological and mechanical properties. The amyloid fibril formation has contrasting results depending on the organism, in the sense that it can bestow an organism with the advantages of mechanical strength and improved functionality or, on the contrary, could give rise to pathological states. In this chapter we review the existing information on amyloid-like peptide aggregates, which could either be derived from protein sequences, but also could be rationally or de novo designed in order to self-assemble into amyloid fibrils under physiological conditions. Moreover, the development of self-assembled fibrillar biomaterials that are tailored for the desired properties towards applications in biomedical or environmental areas is extensively analyzed. We also review computational studies predicting the amyloid propensity of the natural amino acid sequences and the structure of amyloids, as well as designing novel functional amyloid materials.
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Affiliation(s)
- C. Kokotidou
- University of Crete, Department of Materials Science and Technology Voutes Campus GR-70013 Heraklion Crete Greece
- FORTH, Institute for Electronic Structure and Laser N. Plastira 100 GR 70013 Heraklion Greece
| | - P. Tamamis
- Texas A&M University, Artie McFerrin Department of Chemical Engineering College Station Texas 77843-3122 USA
| | - A. Mitraki
- University of Crete, Department of Materials Science and Technology Voutes Campus GR-70013 Heraklion Crete Greece
- FORTH, Institute for Electronic Structure and Laser N. Plastira 100 GR 70013 Heraklion Greece
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36
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Sedlakova Kondelova P, Mannaa A, Bommer C, Abdelaziz M, Daeniker L, di Bella E, Krejci I. Efficacy of P 11-4 for the treatment of initial buccal caries: a randomized clinical trial. Sci Rep 2020; 10:20211. [PMID: 33214593 PMCID: PMC7678830 DOI: 10.1038/s41598-020-77057-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/09/2020] [Indexed: 11/09/2022] Open
Abstract
To investigate the safety and efficacy of Self-Assembling Peptide P11-4 (SAP P11-4) compared to placebo or fluoride varnish (FV), a randomized, controlled, blinded, split-mouth study with sequential design was conducted. Subjects presenting two teeth with White-Spot-Lesions (WSLs) were included and teeth were randomly assigned to test or control. Control received placebo at baseline (D0) and test SAP P11-4, all received FV at Day 90 (D90). Standardized photographs were taken at each visit, and WSL size changes were morphometrically assessed. Hierarchical Linear Modelling, considering paired and sequential design, was used to test four hypotheses. SAP P11-4 lesions (test, D90–D0) showed significant WSL size reduction compared to placebo (control, D90–D0; p = 0.008) or FV (control, D180–D90; p = 0.001). Combination of SAP P11-4 and delayed FV after 90 days (test, D180–D0), showed a significant difference compared to FV alone (control D270–D90; p = 0.003). No significant difference on FV efficacy was found when SAP P11-4 was applied 3 months before FV (test D270–D90; control D270–D90, p = 0.70). SAP P11-4 treatment resulted in superior caries regression compared to either placebo or FV, and FV efficacy seems not to be affected by SAP P11-4. SAP P11-4 was found to be a safe and effective WSL treatment.
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Affiliation(s)
| | - Alaa Mannaa
- Division of Operative Dentistry, Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah, 21589, Kingdom of Saudi Arabia
| | | | - Marwa Abdelaziz
- University of Geneva, University Dental Clinics CUMD, rue Michel-Servet 1, 1211, Geneva 4, Switzerland
| | - Laurent Daeniker
- University of Geneva, University Dental Clinics CUMD, rue Michel-Servet 1, 1211, Geneva 4, Switzerland
| | - Enrico di Bella
- Department of Political Sciences, University of Genova, P.le E. Brignole 3a, 16126, Genova, Italy
| | - Ivo Krejci
- University of Geneva, University Dental Clinics CUMD, rue Michel-Servet 1, 1211, Geneva 4, Switzerland.
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38
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El-Sayed B, Davies RPW, El-Zehery RR, Ibrahim FM, Grawish ME, Kirkham J, El-Gendy R. An in-vivo Intraoral Defect Model for Assessing the Use of P 11-4 Self-Assembling Peptide in Periodontal Regeneration. Front Bioeng Biotechnol 2020; 8:559494. [PMID: 33117779 PMCID: PMC7550851 DOI: 10.3389/fbioe.2020.559494] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/31/2020] [Indexed: 12/02/2022] Open
Abstract
Periodontal disease is one of the most common diseases worldwide. It has a significant impact on oral health and subsequently the individual’s quality of life. However, optimal regeneration of periodontal tissues, using current treatments, has yet to be achieved. Peptide self-assembly has provided a step-change in nanobiotechnology and regenerative medicine fields. Our aim was to investigate the effects of a self-assembling peptide (SAP; P11-4) on periodontal regeneration in a preclinical model. Twenty-six bilateral maxillary critical-sized periodontal defects were created surgically in 13 rats. Defects on one side of the mouth were filled with P11-4 hydrogel; the contra-lateral defect was untreated (control). Rats were sacrificed immediately post-surgery (time 0) and after 2 and 4 weeks. Retrieved maxillae were processed for histological, immunohistochemical, and histomorphometric assessments. The results of histological analysis showed greater organization of periodontal fibers in defects treated with P11-4, at both time points, when compared to untreated defects. Histomorphometry showed that treated defects had both a significant increase in functional periodontal ligament length and a reduction in epithelial down growth after 4 weeks. At 2 weeks, treated defects showed a significant increase in expression of osteocalcin and osteoprotegerin as judged by immunohistochemistry. Also, a significantly higher osteoprotegerin/RANKL ratio was shown in treated defects. In conclusion, the results demonstrated enhanced regeneration of periodontal tissues when SAP P11-4 was used to fill periodontal defects in rats. The findings of this study suggest that SAP P11-4 is a promising novel candidate for periodontal regenerative therapy. Further investigations are required for optimization before clinical use.
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Affiliation(s)
- Basmah El-Sayed
- Division of Oral Biology, School of Dentistry, University of Leeds, Leeds, United Kingdom.,Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | | | - Rehab R El-Zehery
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Fatma Mohamed Ibrahim
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mohammed E Grawish
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.,Department of Oral Biology, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Mansoura, Egypt
| | - Jennifer Kirkham
- Division of Oral Biology, School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Reem El-Gendy
- Division of Oral Biology, School of Dentistry, University of Leeds, Leeds, United Kingdom.,Department of Oral Pathology, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
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Jablonski-Momeni A, Nothelfer R, Morawietz M, Kiesow A, Korbmacher-Steiner H. Impact of self-assembling peptides in remineralisation of artificial early enamel lesions adjacent to orthodontic brackets. Sci Rep 2020; 10:15132. [PMID: 32934335 PMCID: PMC7493957 DOI: 10.1038/s41598-020-72185-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022] Open
Abstract
Enamel demineralisation can occur as a side effect during orthodontic treatment with fixed appliances. This study aimed to evaluate the efficacy of the self-assembling peptide P11-4 for remineralisation combined with fluorides, compared to application of fluoride varnish alone. De- and remineralisation was assessed by Quantitative light-induced fluorescence (QLF). Orthodontic brackets were bonded on 108 human enamel samples and white spot lesions were created. The samples were allocated randomly into three groups: Group I received no treatment, group II had a single application of fluoride varnish (22,600 ppm), and group III was treated with P11-4 following a single application of fluoride varnish. Quantitative light-induced fluorescence (QLF) measurements were performed at baseline, after demineralisation and after storage in remineralisation solution for 7 and 30 days. Non-parametric tests (Kruskal-Wallis test and Friedman test) were used for further analysis. After demineralisation, all samples showed a median ΔF -9.38% ± 2.79. After 30 days median ΔF values were as followed: group I = -9.04% ± 2.51, group II = -7.89 ± 2.07, group III = -6.08% ± 2.79). The median ΔF values differed significantly between all groups at all investigation times (p < 0.00001). Application of P11-4 with fluoride varnish was superior to the use of fluorides alone for remineralisation of enamel adjacent to brackets.
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Affiliation(s)
- Anahita Jablonski-Momeni
- Department of Orthodontics, Dental School, Philipps University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
| | - R Nothelfer
- Department of Orthodontics, Dental School, Philipps University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
| | - M Morawietz
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - A Kiesow
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - H Korbmacher-Steiner
- Department of Orthodontics, Dental School, Philipps University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
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40
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Gharaei R, Tronci G, Goswami P, Davies RPW, Kirkham J, Russell SJ. Biomimetic peptide enriched nonwoven scaffolds promote calcium phosphate mineralisation. RSC Adv 2020; 10:28332-28342. [PMID: 35519117 PMCID: PMC9055731 DOI: 10.1039/d0ra02446e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/11/2020] [Indexed: 01/24/2023] Open
Abstract
Cell-free translational strategies are needed to accelerate the repair of mineralised tissues, particularly large bone defects, using minimally invasive approaches. Regenerative bone scaffolds should ideally mimic aspects of the tissue's ECM over multiple length scales and enable surgical handling and fixation during implantation in vivo. Leveraging the knowledge gained with bioactive self-assembling peptides (SAPs) and SAP-enriched electrospun fibres, we presented a cell free approach for promoting mineralisation via apatite deposition and crystal growth, in vitro, of SAP-enriched nonwoven scaffolds. The nonwoven scaffold was made by electrospinning poly(ε-caprolactone) (PCL) in the presence of either peptide P11-4 (Ac-QQRFEWEFEQQ-Am) or P11-8 (Ac QQRFOWOFEQQ-Am), in light of the polymer's fibre forming capability and its hydrolytic degradability as well as the well-known apatite nucleating capability of SAPs. The 11-residue family of peptides (P11-X) has the ability to self-assemble into β-sheet ordered structures at the nano-scale and to generate hydrogels at the macroscopic scale, some of which are capable of promoting biomineralisation due to their apatite-nucleating capability. Both variants of SAP-enriched nonwoven used in this study were proven to be biocompatible with murine fibroblasts and supported nucleation and growth of apatite minerals in simulated body fluid (SBF) in vitro. The fibrous nonwoven provided a structurally robust scaffold, with the capability to control SAP release behaviour. Up to 75% of P11-4 and 45% of P11-8 were retained in the fibres after 7 day incubation in aqueous solution at pH 7.4. The encapsulation of SAP in a nonwoven system with apatite-forming as well as localised and long-term SAP delivery capabilities is appealing as a potential means of achieving cost-effective bone repair therapy for critical size defects. A structurally robust electrospun peptide-enriched scaffold, with controlled peptide release behaviour, supports nucleation and growth of hydroxyapatite minerals in vitro.![]()
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Affiliation(s)
- Robabeh Gharaei
- Clothworkers' Centre for Textile Materials Innovation for Healthcare, University of Leeds UK
| | - Giuseppe Tronci
- Clothworkers' Centre for Textile Materials Innovation for Healthcare, University of Leeds UK .,Division of Oral Biology, School of Dentistry, St James' University Hospital Leeds UK
| | | | - Robert P Wynn Davies
- Division of Oral Biology, School of Dentistry, St James' University Hospital Leeds UK
| | - Jennifer Kirkham
- Division of Oral Biology, School of Dentistry, St James' University Hospital Leeds UK
| | - Stephen J Russell
- Clothworkers' Centre for Textile Materials Innovation for Healthcare, University of Leeds UK
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41
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Lutzweiler G, Ndreu Halili A, Engin Vrana N. The Overview of Porous, Bioactive Scaffolds as Instructive Biomaterials for Tissue Regeneration and Their Clinical Translation. Pharmaceutics 2020; 12:E602. [PMID: 32610440 PMCID: PMC7407612 DOI: 10.3390/pharmaceutics12070602] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/08/2020] [Accepted: 06/23/2020] [Indexed: 12/20/2022] Open
Abstract
Porous scaffolds have been employed for decades in the biomedical field where researchers have been seeking to produce an environment which could approach one of the extracellular matrixes supporting cells in natural tissues. Such three-dimensional systems offer many degrees of freedom to modulate cell activity, ranging from the chemistry of the structure and the architectural properties such as the porosity, the pore, and interconnection size. All these features can be exploited synergistically to tailor the cell-material interactions, and further, the tissue growth within the voids of the scaffold. Herein, an overview of the materials employed to generate porous scaffolds as well as the various techniques that are used to process them is supplied. Furthermore, scaffold parameters which modulate cell behavior are identified under distinct aspects: the architecture of inert scaffolds (i.e., pore and interconnection size, porosity, mechanical properties, etc.) alone on cell functions followed by comparison with bioactive scaffolds to grasp the most relevant features driving tissue regeneration. Finally, in vivo outcomes are highlighted comparing the accordance between in vitro and in vivo results in order to tackle the future translational challenges in tissue repair and regeneration.
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Affiliation(s)
- Gaëtan Lutzweiler
- Institut National de la Santé et de la Recherche Medicale, UMR_S 1121, 11 rue Humann, 67085 Strasbourg CEDEX, France
| | - Albana Ndreu Halili
- Department of Information Technology, Aleksander Moisiu University, 2001 Durres, Albania;
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42
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Yang Z, Xu H, Zhao X. Designer Self-Assembling Peptide Hydrogels to Engineer 3D Cell Microenvironments for Cell Constructs Formation and Precise Oncology Remodeling in Ovarian Cancer. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2020; 7:1903718. [PMID: 32382486 PMCID: PMC7201262 DOI: 10.1002/advs.201903718] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/08/2020] [Indexed: 02/05/2023]
Abstract
Designer self-assembling peptides form the entangled nanofiber networks in hydrogels by ionic-complementary self-assembly. This type of hydrogel has realistic biological and physiochemical properties to serve as biomimetic extracellular matrix (ECM) for biomedical applications. The advantages and benefits are distinct from natural hydrogels and other synthetic or semisynthetic hydrogels. Designer peptides provide diverse alternatives of main building blocks to form various functional nanostructures. The entangled nanofiber networks permit essential compositional complexity and heterogeneity of engineering cell microenvironments in comparison with other hydrogels, which may reconstruct the tumor microenvironments (TMEs) in 3D cell cultures and tissue-specific modeling in vitro. Either ovarian cancer progression or recurrence and relapse are involved in the multifaceted TMEs in addition to mesothelial cells, fibroblasts, endothelial cells, pericytes, immune cells, adipocytes, and the ECM. Based on the progress in common hydrogel products, this work focuses on the diverse designer self-assembling peptide hydrogels for instructive cell constructs in tissue-specific modeling and the precise oncology remodeling for ovarian cancer, which are issued by several research aspects in a 3D context. The advantages and significance of designer peptide hydrogels are discussed, and some common approaches and coming challenges are also addressed in current complex tumor diseases.
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Affiliation(s)
- Zehong Yang
- West China School of Basic Medical Sciences and Forensic MedicineSichuan UniversityChengduSichuan610041P. R. China
- Institute for Nanobiomedical Technology and Membrane BiologyWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
| | - Hongyan Xu
- GL Biochem (Shanghai) Ltd.519 Ziyue Rd.Shanghai200241P. R. China
| | - Xiaojun Zhao
- Institute for Nanobiomedical Technology and Membrane BiologyWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
- Wenzhou InstituteUniversity of Chinese Academy of Sciences (Wenzhou Institute of Biomaterials & Engineering)WenzhouZhejiang325001P. R. China
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43
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Welk A, Ratzmann A, Reich M, Krey KF, Schwahn C. Effect of self-assembling peptide P 11-4 on orthodontic treatment-induced carious lesions. Sci Rep 2020; 10:6819. [PMID: 32321955 PMCID: PMC7176635 DOI: 10.1038/s41598-020-63633-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 03/31/2020] [Indexed: 02/07/2023] Open
Abstract
This study aimed to evaluate the effect of self-assembling peptide P11-4 (SAP) in the therapy of initial smooth surface caries (white spot lesions, WSL) following orthodontic multibracket treatment. Twenty-three patients (13f/10m; average age 15.4 years) with at least two teeth with WSL were recruited for the randomised controlled clinical trial with split-mouth design. In opposite to the control teeth, the test teeth were treated with SAP on Day 0. The primary endpoint was the impedance measurement of WSL using customised tray to ensure reproducibility of the measurement location. The secondary endpoint was the morphometric measurement of WSL using a semi-automated approach to determine the WSL size in mm2. Treatment effects were adjusted for site-specific baseline values using mixed models adapted from the cross-over design. Test WSL showed a mean baseline impedance value of 46.7, which decreased to 21.1, 18.4, and 19.7 after 45, 90, and 180 days, respectively. Control WSL showed a mean baseline value of 42.0, which decreased to 35.0, 29.5, and 33.7, respectively. The overall treatment contrast was -13.7 (95% CI: -19.6 - -7.7; p < 0.001). For the secondary endpoint, the test WSL size decreased from 8.8 at baseline to 6.5 after 180 days. The control WSL decreased from 6.8 to 5.7, respectively. The related treatment contrast was -1.0 in favour of test WSL (95% CI: -1.6 - -0.5; p = 0.004). The treatment of initial carious lesions with self-assembling peptide P11-4 leads to superior remineralisation of the subsurface lesions compared with the control teeth.
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Affiliation(s)
- A Welk
- Dental school of the University Medicine Greifswald, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, Greifswald, Germany.
| | - A Ratzmann
- Dental school of the University Medicine Greifswald, Department of Orthodontics, Greifswald, Germany
| | - M Reich
- Dental school of the University Medicine Greifswald, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, Greifswald, Germany
| | - K F Krey
- Dental school of the University Medicine Greifswald, Department of Orthodontics, Greifswald, Germany
| | - Ch Schwahn
- Dental school of the University Medicine Greifswald, Department of Prosthodontics, Greifswald, Germany
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Doberdoli D, Bommer C, Begzati A, Haliti F, Heinzel-Gutenbrunner M, Juric H. Randomized Clinical Trial investigating Self-Assembling Peptide P 11-4 for Treatment of Early Occlusal Caries. Sci Rep 2020; 10:4195. [PMID: 32144336 PMCID: PMC7060217 DOI: 10.1038/s41598-020-60815-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 02/14/2020] [Indexed: 02/04/2023] Open
Abstract
Non-invasive caries treatment is a major focus in modern dentistry. The present study was designed to evaluate the effectiveness of monomeric self-assembling peptide P11-4 (SAP P11-4) in combination with fluoride varnish or polymeric self-assembling peptide matrix (SAPM) in treatment of non-cavitated occlusal caries. Ninety children and adolescents were included in this randomized, gold-standard-controlled clinical trial. Test Group 1 received SAP P11-4 and twice fluoride varnish at baseline and Day 180, Test Group 2 received SAP P11-4 on baseline and twice weekly SAPM (home-application), and Control Group received fluoride varnish on baseline and Day 180. Caries progression was measured by laser fluorescence, Nyvad Caries Activity, ICDAS-II-codes, and investigator assessments. Laser fluorescence changes demonstrated superior results for Test Group 1 and 2, as values decreased compared to an increase for the Control Group (p < 0.0005). ICDAS-II codes at Day 360 showed partial regression for Test Group 1 (6.7%) and Test Group 2 (20.0%) and partial progression for Control Group (23.3%) (p < 0.01). Nyvad Caries Activity yielded superior caries inactivation for Test Groups, compared to Control Group (p = 0.002). This trial showed that SAP P11-4, applied either in combination with fluoride varnish or twice weekly SAPM, was a superior treatment for early caries compared to fluoride varnish alone.
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Affiliation(s)
- Dafina Doberdoli
- Department of Pediatric Dentistry and Prevention, University Dentistry Clinical Center of Kosovo, Rrethi I spitalit p.n, Pristina, 10000, Kosovo. .,School of Dental Medicine - Department of Pediatric Dentistry and Prevntion, University of Zagreb, Gundulićeva 5, Zagreb, 10000, Croatia.
| | | | - Agim Begzati
- Department of Pediatric Dentistry and Prevention, University Dentistry Clinical Center of Kosovo, Rrethi I spitalit p.n, Pristina, 10000, Kosovo
| | - Fehim Haliti
- Department of Pediatric Dentistry and Prevention, University Dentistry Clinical Center of Kosovo, Rrethi I spitalit p.n, Pristina, 10000, Kosovo
| | | | - Hrvoje Juric
- School of Dental Medicine - Department of Pediatric Dentistry and Prevntion, University of Zagreb, Gundulićeva 5, Zagreb, 10000, Croatia
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Ibrahim M, Labaki M, Giraudon JM, Lamonier JF. Hydroxyapatite, a multifunctional material for air, water and soil pollution control: A review. JOURNAL OF HAZARDOUS MATERIALS 2020; 383:121139. [PMID: 31520935 DOI: 10.1016/j.jhazmat.2019.121139] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/19/2019] [Accepted: 09/02/2019] [Indexed: 05/12/2023]
Abstract
Hydroxyapatite (Ca10(PO4)6(OH)2), a calcium phosphate biomaterial, is a very promising candidate for the treatment of air, water and soil pollution. Indeed, hydroxyapatite (Hap) can be extremely useful in the field of environmental management, due in one part to its particular structure and attractive properties, such as its great adsorption capacities, its acid-base adjustability, its ion-exchange capability and its good thermal stability. Moreover, Hap is able to constitute a valuable resource recovery route. The first part of this review will be dedicated towards presenting Hap's structure and defining properties that result in its viability as an environmental remediation material. The second will focus on its use as adsorbent for wastewater and soil treatment, while indicating the mechanisms involved in this remediation process. Finally, the last part will impart all findings on Hap's applications in the field of catalysis, whether it be as catalyst, as photocatalyst, or as active phase support. Hence, all of the above will have served in showcasing the benefits gained by employing hydroxyapatite in air, water and soil clean-up.
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Affiliation(s)
- Maya Ibrahim
- Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois, UMR 8181 - UCCS - Unité de Catalyse et Chimie du Solide, F-59000 Lille, France; Lebanese University, Faculty of Sciences, Laboratory of Physical Chemistry of Materials LCPM/PR2N, Fanar, Lebanon
| | - Madona Labaki
- Lebanese University, Faculty of Sciences, Laboratory of Physical Chemistry of Materials LCPM/PR2N, Fanar, Lebanon
| | - Jean-Marc Giraudon
- Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois, UMR 8181 - UCCS - Unité de Catalyse et Chimie du Solide, F-59000 Lille, France
| | - Jean-François Lamonier
- Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois, UMR 8181 - UCCS - Unité de Catalyse et Chimie du Solide, F-59000 Lille, France.
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Kamal D, Hassanein H, Elkassas D, Hamza H. Complementary remineralizing effect of self-assembling peptide (P11-4) with CPP-ACPF or fluoride: An in vitro study. J Clin Exp Dent 2020; 12:e161-e168. [PMID: 32071698 PMCID: PMC7018478 DOI: 10.4317/jced.56295] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/08/2019] [Indexed: 11/21/2022] Open
Abstract
Background 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.
Material and Methods 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.
Results 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.
Conclusions 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. Key words:Enamel regeneration, biomimetic remineralization, self-assembling peptide, CPP-ACPF, fluoride.
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Affiliation(s)
- Dina Kamal
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | | | - Dina Elkassas
- Operative Dentistry Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Heba Hamza
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Saha S, Yang XB, Wijayathunga N, Harris S, Feichtinger GA, Davies RPW, Kirkham J. A biomimetic self-assembling peptide promotes bone regeneration in vivo: A rat cranial defect study. Bone 2019; 127:602-611. [PMID: 31351196 DOI: 10.1016/j.bone.2019.06.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 05/31/2019] [Accepted: 06/20/2019] [Indexed: 01/09/2023]
Abstract
Rationally designed, pH sensitive self-assembling β-peptides (SAPs) which are capable of reversibly switching between fluid and gel phases in response to environmental triggers are potentially useful injectable scaffolds for skeletal tissue engineering applications. SAP P11-4 (CH3COQQRFEWEFEQQNH2) has been shown to nucleate hydroxyapatite mineral de novo and has been used in dental enamel regeneration. We hypothesised that addition of mesenchymal stromal cells (MSCs) would enhance the in vivo effects of P11-4 in promoting skeletal tissue repair. Cranial defects were created in athymic rats and filled with either Bio-Oss® (anorganic bone chips) or P11-4 ± human dental pulp stromal cells (HDPSCs). Unfilled defects served as controls. After 4 weeks, only those defects filled with P11-4 alone showed significantly increased bone regeneration (almost complete healing), compared to unfilled control defects, as judged using quantitative micro-CT, histology and immunohistochemistry. In silico modelling indicated that fibril formation may be essential for any mineral nucleation activity. Taken together, these data suggest that self-assembling peptides are a suitable scaffold for regeneration of bone tissue in a one step, cell-free therapeutic approach.
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Affiliation(s)
- Sushmita Saha
- Department of Oral Biology, School of Dentistry, St James's University Hospital, University of Leeds, Leeds, UK
| | - Xuebin B Yang
- Department of Oral Biology, School of Dentistry, St James's University Hospital, University of Leeds, Leeds, UK
| | | | - Sarah Harris
- School of Physics and Astronomy, Astbury Centre for Structural and Molecular Biology, University of Leeds, Leeds, UK
| | - Georg A Feichtinger
- Department of Oral Biology, School of Dentistry, St James's University Hospital, University of Leeds, Leeds, UK
| | - R Philip W Davies
- Department of Oral Biology, School of Dentistry, St James's University Hospital, University of Leeds, Leeds, UK.
| | - Jennifer Kirkham
- Department of Oral Biology, School of Dentistry, St James's University Hospital, University of Leeds, Leeds, UK
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Fabritius-Vilpoux K, Enax J, Herbig M, Raabe D, Fabritius HO. Quantitative affinity parameters of synthetic hydroxyapatite and enamel surfaces in vitro. BIOINSPIRED BIOMIMETIC AND NANOBIOMATERIALS 2019. [DOI: 10.1680/jbibn.18.00035] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Kathia Fabritius-Vilpoux
- Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | - Michael Herbig
- Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany
| | - Dierk Raabe
- Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany
| | - Helge-Otto Fabritius
- Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany
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Randomised clinical trial investigating self-assembling peptide P 11-4 in the treatment of early caries. Clin Oral Investig 2019; 24:123-132. [PMID: 31037343 DOI: 10.1007/s00784-019-02901-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 04/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This prospective, randomised, split-mouth, clinical trial compared the efficacy of the self-assembling peptide P11-4 to fluoride varnish in the treatment of early buccal carious lesions. MATERIALS AND METHODS Subjects presenting at least two clinically affected teeth were treated at D0 (day 0) and D90 with P11-4 (test) or fluoride varnish (control). At D180, fluoride varnish was applied on all study lesions. Standardised photographs were taken at D0, D30, D90, D180 and D360 and blindly morphometrically assessed. Hierarchical linear models (HLM) under allowance of confounders were used to compare the decrease in size between test and control groups. The visual analog scale (VAS) and Global Impression of Change Questionnaire (GICQ) were used as clinical assessments. RESULTS Overall, 37 subjects (13-36 years) with 90 early carious lesions were included. HLM analysis showed a significant difference between test and control groups, indicating a decrease in test lesions and stabilisation of control lesions size (p = 0.001). The test lesion's mean size (SD) relative to baseline decreased to D30 = 0.936(0.127), D90 = 0.874(0.173), D180 = 0.844(0.215) and D360 = 0.862(0.352), whereas control lesions remained stable at D30 = 1.018(0.209), D90 = 1.013(0.207), D180 = 1.029(0.235) and D360 = 1.068(0.401). The effect sizes ranged from 0.47 to 0.82. CONCLUSIONS Within the limits of this study, it was shown that the size of early carious lesions treated with P11-4 was significantly reduced; this result was superior to that of fluoride varnish treatment (DRKS00012941). CLINICAL RELEVANCE The self-assembling peptide P11-4 is the first caries treatment approach aiming to regenerate decayed enamel. P11-4 initiates formation of de novo hydroxyapatite in the depth of early carious lesions, adding a new advanced therapy option for preventive dentistry.
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