Self-assembling peptide P11-4 on early carious lesions: a systematic review of randomized controlled trials

Abstract

Introduction Dental caries is a highly prevalent, multifactorial disease caused by cariogenic bacteria that leads to demineralization of the enamel surface. The initial stage of dental caries, also known as white spot lesions (WSL), can be treated using non-invasive methods that lead to remineralization of the damaged area without reducing healthy tooth structures. In recent years, numerous studies researched an innovative biomimetic remineralizing agent self-assembling peptide (SAP) P11-4. The material can form a three-dimensional matrix within demineralized white spot lesions areas, enhancing the attachment of Ca2+ and PO43– from saliva. This mechanism induces a build-up of new hydroxyapatite crystals, therefore resulting in enamel regeneration. Aim This study aims to evaluate the effect of self- assembling peptide P11-4 on the size, activity and appearance of early carious lesions. Methods This systematic review adhered to the PRISMA statement. Five electronic research databases were searched including Medline (via PubMed), Cochrane Library, ProQuest, Wiley Online Library and Web of Science from the earliest available indexing year through November 2020. Keywords included “self- assembling peptides”, “P11-4”, “mineralization”, “caries”, “carious lesions” and “white spot lesions”. Randomized, blinded and nonblinded, controlled clinical trials with a minimum follow-up period of 3 months were selected for this study. Morphometric analysis, Laser Fluorescence (LF) readings and Nyvad criteria were employed to assess the size, activity and appearance of carious lesions, respectively. The research scope excluded in vitro, in situ, animal studies, review articles, editorial letters, case reports and studies where SAP was used to investigate other purposes. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). Results Database search using the[...].