SELF-ASSEMBLING

PEPTIDE P 11-4
PRESENTED BY
MORGAN FOWLER
KARISSA GRADO
 Researchers at University of Leeds in England :
Jennifer Kirkham- lead researcher

Amalia aggeli- lead researcher

Paul brunton- lead researcher

Dominik lysek- founder and ceo

1997- start of self-assembling peptides studies in dentistry

2007- start of clinical development of peptides in dentistry

2010- first clinical study for enamel regeneration

 RESEARCHERS:

Dominik Jennifer
Lysek Kirkham
 WHAT IS IT?
A peptide is a compound consisting of two or more amino acids
linked in a chain.
A self-assembling peptide undergoes spontaneous assembly to
form nanostructures and repair organic tissues. In dentistry, self-
assembling peptides are used on white-spot or incipient lesions.
NO DRILLING NEEDED! Non-surgical!
NO FILLING NEEDED! Non-invasive!
NO PAIN!
 PEPTIDE P11-4
A combination of peptide monomers that form a 3-dimensional
matrix via hydrogen bonds. When used on a lesion, the fluid
penetrates into the micropores caused by decay and the presence
of calcium ions trigger the self assembly process forming a scaffold
for enamel regeneration. The framework formed can attract calcium
to promote the formation of new hydroxyapatite crystals within the
lesion, healing it from the inside out. The peptide then goes to work
on the enamel matrix which can be regenerated with calcium and
phosphate ions in the saliva. For the peptide to work efficiently
lesions must be accurately identified at the earliest stage of
development for maximum effect.

This product mimics actual tooth formation.

Similar to fluoride varnish, but it is 3X stronger.
Peptide P11-4
matrix
Predicted binding of calcium ions to
surfaces.
 HOW TO APPLY:
Perform Professional oral prophylaxis to ensure a clean
tooth, free from debris
Isolate the tooth to ensure to moisture control
3% Sodium Hypochlorite solution is applied to the
demineralized surface for 20 seconds. This solution is
used to completely disinfect the tooth and clear it
completely from bacteria.
 HOW TO APPLY:
Apply 37% phosphoric acid etch for 30 seconds to open the
micropores. This allows for more surface area for the peptide to
adhere to.
Rinse and dry the tooth completely to remove all etchant.
Tooth is prepped and ready to apply peptide p11-4
 HOW TO APPLY:
Peptide is now literally painted on, similar to fluoride varnish, and
it will be visible for at least 5 minutes. Once it is not visible, it
has successfully absorbed into the demineralized micropores.
This is where the scaffold is formed by the presence of calcium
ions.
Advise the patient to not brush the quadrant containing the
treated tooth until day 4. patients must rinse with a chlorhexidine
wash.
After day 4, the quadrant can be brushed with a soft brush and
tooth paste until day 8, which is when they should return for
recall.
After day 8, patient can return to normal oral hygiene care.
Step 1 Step 2

Step 3 Step 4
 SELECTION FOR CLINICAL TRAILS:
Patients ages 18-65 who were willing and able to have good oral
hygiene were used in the study.
Patients had to have two proximal lesions on different teeth with
at least one tooth in between and did not require operative
intervention.
The lesions must be fully visible in the mouth and on
radiographs.
Patients excluded from the study had reduced salivary flow,
significant tooth wear, systemic disorder, pregnant or breast
feeding, smoke more than 5 cigarettes per day or involved with
another clinical trial were not chosen.
 OUTCOMES FROM TREATMENT:
Patients were reviewed at different intervals to ensure maximum
effect of treatment was achieved. They would come in at Day 4,
8, 30, and 180.
At each visit a visual inspection was performed with adverse
effects noted, vital signs recoded, color photographs of the test
lesion were taken, and a questionnaire was given out on Days 30
and 180.
All clinical findings were compared to the baseline date (Day 1).
The appearance, size, color, and progression of the lesion had
drastically changed by Day 30 and was still effective by Day 180
and post-treatment.
 Appearance, color, size, and
progression changes. Left is pre-
treatment and Right is 6 months post-
treatment.
 ADVERSE EFFECTS OF TREATMENT:
Although 11 recorded adverse effects were noted, only two were
judged as related to the clinical trial protocol. None were
classified as serious.
The first was transient dental hypersensitivity
The second was a sensitivity to the Corsodyl mouthwash
provided within the study.
 VIDEO:

https://www.youtube.com/watch?v=vqeYqBTSWvk
 WHAT IS CURODONT?
Curodont is the product name for peptide P11-4 has been
patented by the company Credentis and is being sold on the
market in Europe and is awaiting approval for use in the United
States.
The cost of the product is $300 U.S. dollars for a box of 10
applicators good to treat 10 teeth.
Dentist is Europe love this product and have not had any
negative feedback to report.
 CONCLUSION:
"This may sound too good to be true, but we are essentially
helping acid-damaged teeth to regenerate themselves. It is a
totally natural nonsurgical repair process and is entirely pain-free
too (Jennifer Kirkham)
"If we can offer a treatment that is completely noninvasive, that
doesn't involve a mechanical drill, then we can change that
perceived link between dental treatment and pain. This really is
more than filling without drilling; this is a novel approach that
enables the patients to keep their natural teeth! (Paul Brunton)
Questions?????
 REFERENCES:
Brunton, P. A., Davies, R. P. W., Burke, J. L., Smith, A., Aggeli, A., Brookes, S.
J., & Kirkham, J. (2013, August 23). Treatment of early caries lesions using
biomimetic self assembling peptides - a clinical safety trial. British Dental
Journal, 215(4), 6.
doi:http://dx.doi.org.libproxy.lamar.edu/10.1038/sj.bdj.2013.741

Jablonski-Momeni, A., & Heinzel-Gutenbrunner, M. (2014, May 15). Efficacy

of the self assembling peptide P11-4 in constructing a remineralization
scaffold on artificially-induced enamel lesions on smooth surfaces. Journal Of
Orofacial Orthopedics/Fortschritte Der Kieferorthopadie, 75(3), 175.
doi:10.1007/s00056-014-0211-2

Prakash, A., Parsons, S.J., Kyle, S., & McPherson, M. J. (2012, July 3).
Recombinant production of self-assembling structured peptides using SUMO
as a fusion partner. Microbial Cell Factories, 11(1), 92-101.
doi:10.1186/1475-2859-1192
 REFERENCES:
Schmidlin, P., Zobrist, Katja., Attin, Thomas., Wegehaupt, Florian.
(2015, November 2). In vitro re-hardening of artificial enamel
caries lesions using enamel matrix proteins or self- assembling
peptides. Journal of Applied Oral Science Vol. 24 No.http
://dx.doi.org/10.1590/1678-77572015052
University of Leeds. (2011, August 23). Filling without drilling:
Pain-free way of tackling dental decay reverses acid damage and
re-builds teeth. ScienceDaily. Retrieved October 25, 2016 from
www.sciencedaily.com/releases/2011/08/110823115402.htm
http
://clinicaltrials.gov/ct2/show/NCT02101255?term=peptide+p11-
4&rank=4
http://credentis.com Regenerating Teeth: The New dimension of
Self-Assembling Peptides. (2017. Jan)