Self-assembling peptide P11-4 in remineralization of enamel caries–a systematic review of in-vitro studies

Abstract

Objective: The present systematic review was conducted to investigate the effect of the self-assembling peptide (SAP)–P11-4 in the remineralization of enamel caries. Material and methods: The systematic search for studies was conducted through CINAHL, EMBASE, MEDLINE, Scopus, PsychINFO, and various key journals. This review was conducted in adherence to PRISMA standards and was registered in PROSPERO with registration number CRD42019110156. The methodological quality of the studies was graded through Cochrane's tool of risk of bias in non-randomized studies–of interventions (ROBINS-I). Results: In total, 91 studies were identified for screening, and 12 studies were eligible. Ten studies showed effective enamel remineralization with P11-4 compared to controls. One study showed a combination of P11-4 with fluoride varnish or Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CPP-ACPF) leads to significantly higher remineralization compared to P11-4 alone. Quality assessment of study showed 6 (50%) studies as medium risk of bias and 6 (50%) studies as low risk of bias. Conclusion: To conclude, the present study results showed SAP- P11-4 is effective in the remineralization of enamel caries.