The Effectiveness of the Self-Assembling Peptide P11-4 in the Remineralization of Enamel Carious White Spot Lesions (WSL-Curodont)
2026년 6월 16일 업데이트: Dorota Olczak-Kowalczyk, Medical University of Warsaw
A Three-arm Randomized Controlled Trial Evaluating the Effectiveness of Self- Assembling Peptide P11-4 in the Remineralization of Enamel Carious White Spot Lesions
This is three-arm Randomized Controlled Trial.
The main goal is to evaluate the effectiveness of self-assembling peptide P11-4 (SAP P11-4) in the remineralization of enamel carious white spot lesions.
Participants with carious white spot lesions will be assigned to one of three study groups and remineralisation agents will be applied according to the study protocol.
The primary objective is to assess changes in the carious white spot lesions over time using quantitative light-induced fluorescence and clinical evaluation.
연구 개요
상태
모병
상세 설명
This study will be conducted at an academic center. Recruitment will include patients aged 10 to 18 years presenting with carious white spot lesions on the smooth surfaces of permanent teeth at the Department of Pediatric Dentistry, Medical University of Warsaw. The planned study duration is 1 year. After assessment of the inclusion and exclusion criteria and enrollment into the study, participants will undergo randomization and will be allocated to 1 of 3 study groups.
Group A will receive a single application of Curodont Repair (self-assembling peptide P11-4) at the first visit, together with fluoride varnish application every 3 months (Duraphat Fluoride Varnish, Colgate, 22,600 ppm fluoride). Group B will receive repeated applications of Curodont Repair at the first visit, after 3 months, together with fluoride varnish application every 3 months. Group C, the control group, will receive only fluoride varnish every 3 months.
There is currently limited evidence regarding the effectiveness of repeated applications of remineralization agents containing self-assembling peptide P11-4. In addition, this study includes a relatively long follow-up period, allowing evaluation of the durability of the treatment effect over time.
At each follow-up visit, scheduled every 3 months, white spot lesions will be assessed using quantitative light-induced fluorescence (QLF) and visual clinical examination.
연구 유형
중재적
등록 (추정된)
75
단계
- 해당 없음
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 연락처
- 이름: Anna Turska-Szybka
- 전화번호: +48 22 116 64 24
- 이메일: pedodoncja@wum.edu.pl
연구 장소
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Masovian Voivodeship
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Warsaw, Masovian Voivodeship, 폴란드, 02-097
- 모병
- University Clinical Center of the Medical University of Warsaw, Department of Pediatric Dentistry
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연락하다:
- Secretariat of the Department of Pediatric Dentistry
- 전화번호: +48 22 116 64 24
- 이메일: pedodoncja@wum.edu.pl
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수석 연구원:
- Dorota Olczak-Kowalczyk, Prof.
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부수사관:
- Anna Turska-Szybka, Assoc. Prof.
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부수사관:
- Julia Sazonowa, Dr.
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참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
건강한 자원 봉사자를 받아들입니다
아니
설명
Inclusion Criteria:
- Age >10 years and <18 years.
- Presence of at least 2 active enamel carious white spot lesions on a smooth tooth surface (labial/buccal surfaces of permanent teeth) based on International Caries Detection (ICDAS II) and Assessment System -Lesion Activity Assessment (ICDAS-LAA), and Lesion Activity Assessment (LAA criteria).
Tooth eligible for treatment:
- Vital pulp,
- no loss of hard dental tissues within the investigated lesion (ICDAS II) code 1 or 2 , LAA code 1, ICDAS-LAA>7;
- QLF score parameters consistent with demineralization without loss of tissue continuity- code 1 or 2),
- no history of trauma to the tooth.
- Systemically healthy patient.
- No contraindications to the use of fluoride preparations.
- No fixed orthodontic appliance.
- Written consent for participation in the study signed by the legal guardian, or by the legal guardian and the patient.
Exclusion Criteria:
- Systemic diseases or chronic medication use due to chronic conditions.
- Viral/bacterial illness on the day of the visit, e.g., herpetic stomatitis, influenza, tonsillitis (temporary restriction).
- Pregnancy or breastfeeding.
- Allergy to any component of the SAP P11-4 preparation or the fluoride varnish.
- Professional fluoride prophylaxis performed <3 months ago.
- Presence of cavitation (loss of hard tissues) in the treated tooth - ICDAS II code ≥3, ICDAS-LAA<7, LAA code 0, 2-9.
- Carious WSL previously treated with the Icon resin infiltrant (methacrylate resin).
- Developmental enamel defects.
- Patient undergoing orthodontic treatment with fixed appliances.
- Inability to ensure regular follow-up visits.
- Lack of cooperation from the guardian or the patient.
- Refusal to participate in the study and/or absence of written consent.
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Single Application of Curodont Repair Plus Fluoride Varnish
Participants will receive a single application of Curodont Repair (self-assembling peptide P11-4) at the first visit (baseline) and fluoride varnish application every 3 months (including baseline visit)
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Self-assembling peptide P11-4 will be applied on enamel carious white spot lesions according to the study protocol.
In the single-application group (group A), the agent will be applied once at the first visit(baseline).
In the repeated-application group (group B), the agent will be applied at the first visit (baseline) and after 3 months.
Fluoride varnish will be applied every 3 months according to the study protocol.
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실험적: Repeated Application of Curodont Repair Plus Fluoride Varnish
Participants will receive applications of Curodont Repair (self-assembling peptide P11-4) at the first visit (baseline), after 3 months, together with fluoride varnish application every 3 months (including baseline visit).
|
Self-assembling peptide P11-4 will be applied on enamel carious white spot lesions according to the study protocol.
In the single-application group (group A), the agent will be applied once at the first visit(baseline).
In the repeated-application group (group B), the agent will be applied at the first visit (baseline) and after 3 months.
Fluoride varnish will be applied every 3 months according to the study protocol.
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활성 비교기: Fluoride Varnish Only
Participants will receive fluoride varnish application every 3 months only.
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Fluoride varnish will be applied every 3 months according to the study protocol.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Change in Fluorescence Loss (ΔF) of White Spot Lesions From Baseline to 12 Months Assessed by Quantitative Light-Induced Fluorescence
기간: baseline and 12 months follow-up
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The primary outcome measure is the change in fluorescence loss of white spot lesions from baseline to the 12-month follow-up, assessed using quantitative light-induced fluorescence (QLF).
Fluorescence loss will be measured using the QLF parameter ΔF and expressed as percentage fluorescence loss (%).
More negative ΔF values indicate greater mineral loss.
The change will be calculated as the ΔF value at 12 months minus the ΔF value at baseline.
A positive change in ΔF from baseline, indicating an increase in ΔF toward zero, will indicate lesion remineralization.
A negative change in ΔF from baseline will indicate lesion demineralization.
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baseline and 12 months follow-up
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Change in lesion volume ΔQ of White Spot Lesions From Baseline to 12 Months Assessed by Quantitative Light-Induced Fluorescence
기간: from baseline to the 12-month follow-up
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The primary outcome measure is the change in QLF lesion volume (ΔQ) from baseline to the 12-month follow-up.
ΔQ will be assessed using quantitative light-induced fluorescence (QLF) and expressed as % × mm².
The change will be calculated as the ΔQ value at 12 months minus the ΔQ value at baseline.
More negative ΔQ values indicate larger or more severe lesions.
Therefore, a positive change in ΔQ from baseline indicates lesion improvement, whereas a negative change in ΔQ from baseline indicates lesion progression.
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from baseline to the 12-month follow-up
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Change in QLF Fluorescence Loss (ΔF) of White Spot Lesions From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Fluorescence loss will be assessed using the QLF parameter ΔF and expressed as percentage fluorescence loss (%).
More negative ΔF values indicate greater mineral loss.
The change will be calculated as the ΔF value at each follow-up visit minus the ΔF value at baseline.
A positive change in ΔF from baseline, indicating an increase in ΔF toward zero, will indicate lesion remineralization.
A negative change in ΔF from baseline will indicate lesion demineralization.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Change in Lesion Area of White Spot Lesions From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Lesion area will be assessed using quantitative light-induced fluorescence (QLF) and expressed in square millimeters (mm²).
The change will be calculated as the lesion area at each follow-up visit minus the lesion area at baseline.
A decrease in lesion area from baseline indicates lesion improvement, whereas an increase in lesion area from baseline indicates lesion progression.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Change in QLF Lesion Volume (ΔQ) of White Spot Lesions From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Lesion volume will be assessed using the QLF parameter ΔQ and expressed as % × mm².
More negative ΔQ values indicate larger or more severe lesions.
An increase in ΔQ toward zero, or a positive change in ΔQ from baseline, will indicate lesion improvement.
A decrease in ΔQ, or a negative change in ΔQ from baseline, will indicate lesion progression.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Mean ICDAS II Score From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Caries lesion severity will be assessed using the International Caries Detection and Assessment System II (ICDAS II).
The ICDAS II score ranges from 0 to 6, where 0 indicates a sound tooth surface and 6 indicates an extensive distinct cavity with visible dentin.
Higher scores indicate greater caries lesion severity.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Mean ICDAS-Lesion Activity Assessment Score From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Lesion activity will be assessed using the ICDAS-Lesion Activity Assessment (ICDAS-LAA) criteria.
The ICDAS-LAA score is calculated by summing points assigned for clinical parameters including visual appearance, gingival inflammation with plaque stagnation, and surface texture.
The total score ranges from 4 to 11 points, with scores ≤7 indicating inactive caries and scores >7 indicating active caries.
Higher scores indicate greater lesion activity.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Number of Lesions in Each Nyvad Lesion Activity Assessment Category From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Lesion activity will be assessed using the Nyvad Lesion Activity Assessment (LAA) criteria.
Each lesion will be classified into one of the following categories: 0 = sound surface, 1 = active caries with intact surface, 2 = active caries with surface discontinuity, 3 = active caries with cavity, 4 = inactive caries with intact surface, 5 = inactive caries with surface discontinuity, 6 = inactive caries with cavity, 7 = filling with sound surface, 8 = filling with active caries, and 9 = filling with inactive caries.
Results will be reported as the number of lesions in each category.
Higher category numbers do not necessarily indicate a better or worse outcome, as the categories represent lesion/restoration status and caries activity.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Mean Plaque Index Score From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Dental plaque accumulation will be assessed using the Plaque Index (PLI).
The PLI is scored from 0 to 3, where 0 indicates no plaque and 3 indicates abundant soft deposits.
The mean PLI score will be calculated for each participant based on four surfaces per tooth.
Higher scores indicate greater plaque accumulation.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Mean Gingival Index Score From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Gingival inflammation will be assessed using the Gingival Index (GI).
The GI is scored from 0 to 3, where 0 indicates normal gingiva and 3 indicates severe inflammation.
The mean GI score will be calculated for each participant based on four surfaces per tooth.
Higher scores indicate worse gingival inflammation.
The results will be interpreted as follows: 0 = healthy gingiva, 0.1-1.0
= mild inflammation, 1.1-2.0
= moderate inflammation, and 2.1-3.0 = severe inflammation.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Percentage of Sites With Bleeding on Probing From Baseline to Each Follow-up Visit
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Gingival status will be assessed using Bleeding on Probing (BOP).
BOP will be expressed as the percentage of sites with bleeding on probing.
Gingival status will be categorized as healthy/no gingivitis when BOP is <10%, localized gingivitis when BOP is 10-30%, and generalized gingivitis when BOP is >30%.The BOP percentage (BOP%) will be calculated as: BOP% = (Number of bleeding sites ÷ Total number of sites examined) × 100
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Mean Visual Analogue Scale Score for Patient-reported Tolerability
기간: Baseline, 3 months, 6 months, 9 months, and 12 months
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Patient-reported tolerability will be assessed using the Visual Analogue Scale.
The scale ranges from 0 to 10, with higher scores indicating worse tolerability.
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Baseline, 3 months, 6 months, 9 months, and 12 months
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Number of Adverse Events Throughout the Study Period
기간: Baseline through 12 months
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Occurrence of adverse events (AEs) recorded throughout the study period.
Adverse events will be reported as the number of participants experiencing at least one adverse event.
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Baseline through 12 months
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Dorota Olczak-Kowalczyk, Prof., Medical University of Warsaw
간행물 및 유용한 링크
연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.
일반 간행물
- Loe H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol. 1967 Nov-Dec;38(6):Suppl:610-6. doi: 10.1902/jop.1967.38.6.610. No abstract available.
- Dikmen B. Icdas II criteria (international caries detection and assessment system). J Istanb Univ Fac Dent. 2015 Oct 21;49(3):63-72. doi: 10.17096/jiufd.38691. eCollection 2015.
- ÜÇTAŞLI, M. B., AKGÜL, S., UYSAL, G. Ç., AHISHA, C. D., KESKİN, A. Ş., & TOPBAŞ, N. K. (2025). SCIENTIFIC FOUNDATIONS AND CLINICAL DIRECTIONS IN DENTISTRY: REMINERALIZATION, RADIATION AND RESTORATION. In SCIENTIFIC FOUNDATIONS AND CLINICAL DIRECTIONS IN DENTISTRY: REMINERALIZATION, RADIATION AND RESTORATION. Zenodo. https://doi.org/10.5281/zenodo.15670487
- Parums DV. Editorial: The 2024 Revision of the Declaration of Helsinki and its Continued Role as a Code of Ethics to Guide Medical Research. Med Sci Monit. 2024 Dec 1;30:e947428. doi: 10.12659/MSM.947428.
- Hussain U, Kunwar SS, Khan UW, Kamran MA, Thakfan AS, Alshahrani OA, Rehman A, Niazi FH, Shah AM, Alam S, Campobasso A. Efficacy of various interventions for the management of white spot lesions associated with fixed orthodontic treatment: a systematic review and network meta-analysis of randomized controlled trials. BMC Oral Health. 2026 Feb 21;26(1):358. doi: 10.1186/s12903-026-07755-3.
- Soliman EM, Abdelfattah WM, Mohamed DR, Nagui DA, Holiel AA. Clinical evaluation of the remineralizing potential of biomimetic scaffolds on enamel white spot lesions: A 12-month randomized controlled trial. J Dent. 2026 Mar;166:106303. doi: 10.1016/j.jdent.2025.106303. Epub 2025 Dec 16.
- Sawair FA, Ryalat S, Shayyab M, Saku T. The unstimulated salivary flow rate in a jordanian healthy adult population. J Clin Med Res. 2009 Oct;1(4):219-25. doi: 10.4021/jocmr2009.10.1267. Epub 2009 Oct 16.
- Patel JS, Shin D, Willis L, Zai A, Kumar K, Thyvalikakath TP. Comparing gingivitis diagnoses by bleeding on probing (BOP) exclusively versus BOP combined with visual signs using large electronic dental records. Sci Rep. 2023 Oct 10;13(1):17065. doi: 10.1038/s41598-023-44307-z.
- Elaziz BSA, Hamdy D, Galal M, Khattab NMA. The remineralizing ability of self-assembling peptide P11-4, 2% arginine enriched sodium fluoride and functionalized tri calcium phosphate fluoride varnishes in treatment of white spot lesions - a randomized controlled trial. BDJ Open. 2025 Jul 27;11(1):70. doi: 10.1038/s41405-025-00353-5.
- Nyvad B, Baelum V. Nyvad Criteria for Caries Lesion Activity and Severity Assessment: A Validated Approach for Clinical Management and Research. Caries Res. 2018;52(5):397-405. doi: 10.1159/000480522. Epub 2018 Mar 5.
- Ekstrand KR, Martignon S, Ricketts DJ, Qvist V. Detection and activity assessment of primary coronal caries lesions: a methodologic study. Oper Dent. 2007 May-Jun;32(3):225-35. doi: 10.2341/06-63.
- Ding L, He D, Zheng S, Zhou X, Li H, Xi Y, Wang X, Sun X. In-vitro and in-vivo comparative studies of treatment effects on enamel demineralization during orthodontic therapy: implications for clinical early-intervention strategy. Clin Oral Investig. 2024 Sep 24;28(10):545. doi: 10.1007/s00784-024-05944-4.
- Oh SH, Lee SR, Choi JY, Choi YS, Kim SH, Yoon HC, Nelson G. Detection of Dental Caries and Cracks with Quantitative Light-Induced Fluorescence in Comparison to Radiographic and Visual Examination: A Retrospective Case Study. Sensors (Basel). 2021 Mar 3;21(5):1741. doi: 10.3390/s21051741.
- Tan R, Zhu X, Chen S, Zhang J, Liu Z, Li Z, Fan H, Wang X, Yang L. Caries lesions diagnosis with deep convolutional neural network in intraoral QLF images by handheld device. BMC Oral Health. 2024 Jun 29;24(1):754. doi: 10.1186/s12903-024-04517-x.
- La Rosa GRM, Pedulla E, Chapple I, Pacino SA, Polosa R. The use of quantitative light-induced fluorescence in carious lesions research: A bibliometric review. J Dent. 2024 Sep;148:105220. doi: 10.1016/j.jdent.2024.105220. Epub 2024 Jun 30.
- Shaalan O, Fawzy El-Sayed K, Abouauf E. Evaluation of the remineralization potential of self-assembling peptide P11-4 with fluoride compared to fluoride varnish in the management of incipient carious lesions: a randomized controlled clinical trial. Clin Oral Investig. 2024 Jul 22;28(8):438. doi: 10.1007/s00784-024-05822-z.
- Gohar RAAEG, Ibrahim SH, Safwat OM. Evaluation of the remineralizing effect of biomimetic self-assembling peptides in post-orthodontic white spot lesions compared to fluoride-based delivery systems: randomized controlled trial. Clin Oral Investig. 2023 Feb;27(2):613-624. doi: 10.1007/s00784-022-04757-7. Epub 2022 Oct 26.
- Klimaite G, Vasiliauskas A, Grinkevicius P, Grinkeviciene D, Sapalas D. The Efficacy of Remineralizing Materials on Artificial Enamel Lesions: An In Vitro Study. Medicina (Kaunas). 2025 Mar 6;61(3):462. doi: 10.3390/medicina61030462.
- Kamal D, Hassanein H, Elkassas D, Hamza H. Complementary remineralizing effect of self-assembling peptide (P11-4) with CPP-ACPF or fluoride: An in vitro study. J Clin Exp Dent. 2020 Feb 1;12(2):e161-e168. doi: 10.4317/jced.56295. eCollection 2020 Feb.
- Kobeissi R, Badr SB, Osman E. Effectiveness of Self-assembling Peptide P11-4 Compared to Tricalcium Phosphate Fluoride Varnish in Remineralization of White Spot Lesions: A Clinical Randomized Trial. Int J Clin Pediatr Dent. 2020 Sep-Oct;13(5):451-456. doi: 10.5005/jp-journals-10005-1804.
- Atteya SM, Amer HA, Saleh SM, Safwat Y. Self-assembling peptide and nano-silver fluoride in remineralizing early enamel carious lesions: randomized controlled clinical trial. BMC Oral Health. 2023 Aug 19;23(1):577. doi: 10.1186/s12903-023-03269-4.
- Sedlakova Kondelova P, Mannaa A, Bommer C, Abdelaziz M, Daeniker L, di Bella E, Krejci I. Efficacy of P11-4 for the treatment of initial buccal caries: a randomized clinical trial. Sci Rep. 2020 Nov 19;10(1):20211. doi: 10.1038/s41598-020-77057-3.
- Doberdoli D, Bommer C, Begzati A, Haliti F, Heinzel-Gutenbrunner M, Juric H. Randomized Clinical Trial investigating Self-Assembling Peptide P11-4 for Treatment of Early Occlusal Caries. Sci Rep. 2020 Mar 6;10(1):4195. doi: 10.1038/s41598-020-60815-8.
- Guven E, Eden E, Attin R, Firinciogullari EC. Remineralization of post-orthodontic white spot lesions with a fluoride varnish and a self-assembling P 11 - 4 peptides: a prospective in-vivo-study. Clin Oral Investig. 2024 Aug 3;28(8):464. doi: 10.1007/s00784-024-05865-2.
- Babu B, Padawe D, Takate V. Remineralization Potential of Self-Assembling Peptides Versus Fluoride Agents in White Spot Lesions: A Systematic Review. Cureus. 2025 Oct 25;17(10):e95416. doi: 10.7759/cureus.95416. eCollection 2025 Oct.
- Jablonski-Momeni A, Temming T, Berthold JN, Olbrisch C, Diekmeier C, Bottenberg P, Korbmacher-Steiner H. A prospective, triple-blind, randomized controlled clinical trial evaluating the protective effect of P11-4 peptide on enamel demineralization during multibracket orthodontic treatment. BMC Oral Health. 2026 Jan 9;26(1):379. doi: 10.1186/s12903-025-07642-3.
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유용한 링크
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (실제)
2026년 2월 2일
기본 완료 (추정된)
2027년 10월 31일
연구 완료 (추정된)
2027년 12월 14일
연구 등록 날짜
최초 제출
2026년 6월 10일
QC 기준을 충족하는 최초 제출
2026년 6월 16일
처음 게시됨 (실제)
2026년 6월 23일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 6월 23일
QC 기준을 충족하는 마지막 업데이트 제출
2026년 6월 16일
마지막으로 확인됨
2026년 6월 1일
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
- CURODONT-WSL-2026
개별 참가자 데이터(IPD) 계획
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미국 FDA 규제 의약품 연구
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