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NCT Number: NCT03927794

Remineralization of White Spot Lesions Using Self-Assembling Peptide P11-4 in Primary Anterior Teeth A Randomized Clinical Trial

This study is a randomized controlled clinical trial on primary anterior teeth of 3-5 year-old patients suffering from white spot lesions (ICDAS system II scores 1-2).

Forty four teeth will be divided into two groups where Group 1 (n=22 teeth) will receive Self-Assembling Peptide P11-4.

Group 2 (n=22 teeth) will receive Topical Fluoride Varnish Application.

Assessment will be done at baseline using the International Caries Detection and Assessment System II (ICDAS II) scoring system and Light Induced Fluorescence using Soprolife System (Acteon, La Ciotat, France) and then after 3 months, 6 months and 1 year. The assessment of the baseline and follow up data will be performed by the main investigator.

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Key information

Conditions

White Spot Lesions [Initial Caries] on Smooth Surface of Tooth

Age range

3 year–5 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ain Shams University

Cairo, 11353, Egypt

About this study

Patients aged 3-5 years with 44 teeth affected by white spot lesions (WSL) on their primary anterior teeth (ICDAS II scores 1-2) will be selected by simple random sample.

A minimum of 1 tooth and a maximum of 12 teeth affected by WSL in each patient can be included.

Subjects whose parents are willing and able to maintain good oral hygiene for their children and attend study visits.Subjects not on medication affecting their salivary flow and medically free (ASA class I).

  • All participating patients' parents will sign an informed consent.
  • Patients will receive oral information on oral health education on how to maintain a proper oral hygiene and proper diet consumption.
  • They will be given manual tooth brushes and non-fluoridated tooth pastes to use during the study. The tooth brushes will be replaced every 3 months and the tooth pastes will be replaced whenever they are empty.
  • Every patient will receive prophylaxis (polishing) using non-fluoridated prophylaxis paste prior to the commencement of treatment to avoid possible confounding factors.
  • Then each patient will be assigned to one of the two groups:

Group A: Self Assembling Peptides P11-4 (SAP Curodont Repair, Credentis, Windisch, Switzerland) 1) Twenty two teeth will receive treatment by self-assembling peptides P11-4 at baseline and will be followed up at 3 months, 6 months and 1 year using the above-mentioned measurements.

Group B: Topical Fluoride Varnish (Duraphat Varnish containing 22,600ppm fluoride, Colgate-Palmolive, USA)

  • Twenty two teeth will receive treatment by topical fluoride varnish at Day 0 and will be followed up after 3 months, 6 months and 1 year using the above-mentioned measurements.

The assessment of the baseline and follow up data will be performed by the main investigator.

Assessment will be done at baseline using the ICDAS II and Light Induced Fluorescence using Soprolife System (Acteon, La Ciotat, France) and then at 3 months, 6 months and 1 year.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Healthy patients ASA Class I.
  • ≥1 Primary Anterior Teeth with early carious lesions of ICDAS scores 1-2.
  • Subjects whose parents are willing and able to maintain good oral hygiene for their children and attend study visits.
  • Patients aged between 3-5 years.
  • Subjects with a minimum of 1 and a maximum of 12 primary anterior teeth with early carious lesions of ICDAS II scores 1-2.

Exclusion criteria

  • Primary anterior teeth in which carious lesions are scored with ICDAS ≥3.
  • Subjects on medication that affects the salivary flow rate.

Treatment and study plan

Self-assembling peptide P11-4

Other

Self-Assembling Peptide P11-4 promotes subsurface biomimetic remineralization of enamel. It is a small peptide comprising 11 amino acids that when applied to an initial carious lesion diffuses into the body of the lesion, re-assembles itself into fibrils forming larger fibers and hence a 3-dimensional (3-D) matrix is formed. Natural remineralization driven by saliva is promoted through the surface of the P11-4 by increasing the surface area for calcium phosphate deposition. As a result, mineralization of the subsurface lesion occurs possibly due to the formation of de novo hydroxyapatite crystals on the surface of the P11-4 fibers.

Other names: Curodont Repair

Primary outcomes

  1. Remineralization of white spot lesions

    Time frame: One year

    Remineralizing efficacy of self-assembling peptide P11-4 versus fluoride varnish using light induced fluorescence (Soprolife Camera). Patients' white spot lesions will be examined using Soprolife camera to identify the demineralized areas. At 3 months, 6 months, and 1 year after treatment their lesions will be re-assessed and compared with baseline data.

Secondary outcomes

  1. Caries progression or regression by ICDAS II system

    Time frame: One year

    Caries progression/ regression using ICDAS II system. If the score has increased to ICDAS 3 or more indicates caries progression and if it decreases to 0-1 this indicates caries regression; if score remains the same this indicates no change in lesion.

    Each lesion will be scored at baseline by ICDAS II system and then at 3 months, 6 months, and 1 year.

  2. - Patient satisfaction/dissatisfaction

    Time frame: 1 day

    • Patient satisfaction/dissatisfaction regarding each intervention using a Caregiver Satisfaction Questionnaire for each patient undergoing the treatment. This will be done on the same visit of treatment after its application.

Sponsors and collaborators

Lead sponsor

Ain Shams University

Other

Registry information

Official study title

Biomimetic Remineralization Using Self-Assembling Peptide P11-4 in the Prevention and Treatment of Early Carious Lesions in Primary Anterior Teeth: An In-Vivo and In-Vitro Study

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Apr 25, 2019
Registry last updated
Dec 15, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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