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=peptid
e+p11-4&rank=4
http://credentis.com Regenerating Teeth: The New
dimension of Self-Assembling Peptides. (2017. Jan)