Self Assembling Peptide P11-4 for management of white spot lesions in subjects undergoing orthodontic treatment

White Spot Lesions (WSLs) are early signs of enamel demineralization, often occurring during orthodontic treatment due to hindered oral hygiene maintenance. Traditional treatment methods include resin infiltration or remineralization using fluoride-based agents. However, self-assembling peptides (SAPs), such as Curodont ™ Repair (P11-4), have emerged as potential alternatives for WSL management. This review comprehensively examines the chemistry, mode of action, clinical safety, and efficacy of SAP P11-4 in remineralizing enamel lesions. It synthesizes findings from studies investigating SAP P11-4's remineralizing potential using various assessment methods, including pH cycling models, laser fluorescence, digital subtraction radiography, and confocal microscopy. SAP P11-4, with its ability to mimic the enamel matrix and promote hydroxyapatite nucleation, demonstrates promising outcomes in reducing WSL size and progression. Clinical studies report significant improvements in lesion remineralization with SAP P11-4 treatment, often surpassing the efficacy of fluoride-based interventions. Moreover, SAP P11-4 shows compatibility with bonding procedures and potential for reducing dentin hypersensitivity. They offer a promising alternative or adjunct to traditional fluoride-based treatments for WSL management, providing clinicians with a valuable tool in promoting enamel health and preventing caries progression. Further research is warranted to explore long-term outcomes and optimize treatment protocols for maximum efficacy.