Comparative analysis of the effect of self-assembling peptide P₁₁-4 on enamel erosion: a confocal laser scanning microscopy study

Objectives

This study aims to comparatively assess the preventive and protective effects of the self-assembling peptide P₁₁-4 on enamel erosion and evaluate the potential for enamel surface recovery when professional products are combined with home-use dental-care products during the erosive process.

Materials and methods

Ninety-nine bovine incisors were divided into nine groups: a control group, four groups with the application of professional-products [P₁₁-4 peptide (Curodont-Repair), stannous/Sn²⁺ containing solution (8% Sn²⁺), casein-phosphopeptide-amorphous-calcium-phosphate fluoride/CPP-ACPF (MI Varnish), sodium fluoride/NaF (Profluorid)] and four groups with the combination of professional products and home-use daily dental care products [P₁₁-4 peptide (Curodont Repair + Curodont Protect), stannous ions containing agents (8% Sn²⁺+Emofluor Gel Intensive-Care), CPP-ACPF (MI Varnish + MI Paste Plus), NaF (Profluorid + ReminPro)].

Professional products were applied once before a five-day erosive cycle, involving six 2-minute citric-acid exposures per day. In combined-groups, a home-use dental-care product was applied daily at the end of each cycle day. After the cycle, lesion depth and fluorescence were analyzed using confocal-laser-scanning-microscopy, and results were statistically evaluated using paired t-tests, ANOVA, and Tukey’s post-hoc tests.

Results

The P₁₁-4 group was significantly more effective among the professional-only groups in both parameters (p<0.001). All combined-groups were determined to be statistically more successful than their respective professional-groups in both parameters (p<0.05). Based on lesion depth data, it was observed that the P₁₁-4 and stannous-containing combined-groups showed statistically similar results (p>0.05). In terms of lesion fluorescence data, the P₁₁-4 combined-group was found to be statistically more successful than all other study groups (p<0.05).

Conclusion

The self-assembling peptide P₁₁-4 was determined to exhibit the best preventive and protective anti-erosive effect in both professional and combined applications.

Clinical Relevance

A positive relationship was observed between the support of professional applications with home-use daily-dental-care products and protection against erosive lesions.