Combined Effect of a Bioinspired Self-Assembling Peptide and Fluoride Varnish on Remineralisation of Artificial Early Enamel Caries Lesion: An in vitro Study

Introduction: This study aimed to investigate the remineralisation effect of combined use of a bioinspired self-assembling peptide (P26) and fluoride varnish on artificial early enamel caries lesions. Methods: Bovine enamel blocks with artificial early enamel caries lesions were prepared. The blocks were randomly allocated to four experimental groups to receive the following treatments: A = P26 + fluoride varnish, B = P26, C = fluoride varnish, and D. distilled water (negative control). The treated blocks were subjected to pH cycling. Enamel blocks were collected at time points of 7 days (d7) and 21 days (d21). The mineral gain, elemental analysis and crystal characteristics of the caries lesion were assessed by micro-computed tomography, scanning electron microscopy with energy dispersive X-ray and X-ray diffraction (XRD), respectively. Results: The mean +/- standard deviation of mineral gain of group A to D were 17.4 +/- 4.2%, 10.7 +/- 2.2%, 10.1 +/- 1.2%, and 6.8 +/- 0.5% at d7, respectively, and 15.2 +/- 2.6%, 8.7 +/- 3.1%, 9.7 +/- 1.2%, and 7.8 +/- 2.3% at d21, respectively. A significant higher mineral gain was observed in group A when compared to other groups at both d7 and d21 (p < 0.05). The calcium-to-phosphate ratio remained consistent across all groups, ranging between 1.2 and 1.4. XRD analysis indicated that crystal composition on the surfaces was apatite for all groups. Conclusion: In conclusion, the present study provided a first indication of better remineralisation effects of the combined use of the bioinspired self-assembling peptide P26 and fluoride varnish compared to the effects of the respective individual uses of P26 or fluoride varnish.