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Review
. 2022 May-Jun;12(3):324-331.
doi: 10.1016/j.jobcr.2022.03.012. Epub 2022 Mar 29.

Remineralization of early enamel caries lesions using self-assembling peptides P11-4: Systematic review and meta-analysis

Aparna B K  1 , Yashoda R  1 , Manjunath P Puranik  1
Affiliations
Review

Remineralization of early enamel caries lesions using self-assembling peptides P11-4: Systematic review and meta-analysis

Aparna B K et al. J Oral Biol Craniofac Res. 2022 May-Jun.

Abstract

Objectives: To compare the effectiveness of self-assembling peptides (SAP) P11-4 in remineralising early enamel lesions to that of other remineralising agents.

Methods: This review was conducted according to PRISMA guidelines. MEDLINE (PubMed), Cochrane and Google Scholar databases were searched up to June 2021. For qualitative analysis, randomised controlled trials and in-vitro investigations were included. For quantitative synthesis, randomised controlled trials with comparable outcomes were used. The risk of bias assessment and meta-analysis were carried out using the RoB 2 tool and RevMan software.

Results: This systematic review and meta-analysis included a total of 12 in-vitro studies and 6 randomised controlled trials. SAP P11-4 had superior effect in remineralising early enamel lesions compared to control groups. In Meta-analysis, SAP P11-4 showed superior remineralization when measured using the VAS data {SMD [-0.61 (-0.88, -0.34)]}; significant caries regression according to Nyvad criteria {OR [0.16(0.03,0.88)]}; and significant improvement in the extent of demineralization in test group {SMD [-0.67 (-1.29, -0.05)]} when measured for fluorescence in comparison with other remineralising agents. On the other hand, morphometric measurements {MD [-0.12(-0.25, -0.00)]} and ICDAS criteria {OR [4.91(0.80, 30.22)]} found no difference among the tested materials.

Conclusions: Both in-vitro and in-vivo studies showed evidence of superior biomimetic remineralization in the SAP P11-4 group compared to other remineralising agents. However, long term studies are necessary to confirm its suitability in clinical use.

Keywords: Early enamel caries; P11-4; Regeneration; SAP, Self-Assembling Peptides; Self-assembling peptides; Tooth remineralization.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Search strategy for PubMed.
Fig. 2
Fig. 2
PRISMA flowchart describing the article screening procedure.
Fig. 3
Fig. 3
Forest plot and risk of bias of studies comparing VAS data for caries progression, relative lesion size of the morphometric measurements, ICDAS class for lesion regression, Nyvad criteria for caries activity and changes in laser fluorescence readings in SAP P11-4 and control groups at day 90.
See this image and copyright information in PMC

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