Remineralization of White Spot Lesions Using Self-Assembling Peptide P11-4 in Primary Anterior Teeth A Randomized Clinical Trial

Patients aged 3‐5 years with 44 teeth affected by white spot lesions (WSL) on their primary anterior teeth (ICDAS II scores 1‐2) will be selected by simple random sample. A minimum of 1 tooth and a maximum of 12 teeth affected by WSL in each patient can be included. Subjects whose parents are willing and able to maintain good oral hygiene for their children and attend study visits.Subjects not on medication affecting their salivary flow and medically free (ASA class I). 1. All participating patients' parents will sign an informed consent. 2. Patients will receive oral information on oral health education on how to maintain a proper oral hygiene and proper diet consumption. 3. They will be given manual tooth brushes and non‐fluoridated tooth pastes to use during the study. The tooth brushes will be replaced every 3 months and the tooth pastes will be replaced whenever they are empty. 5) Every patient will receive prophylaxis (polishing) using non‐fluoridated prophylaxis paste prior to the commencement of treatment to avoid possible confounding factors. 6) Then each patient will be assigned to one of the two groups: Group A: Self Assembling Peptides P11‐4 (SAP Curodont Repair, Credentis, Windisch, Switzerland) 1) Twenty two teeth will receive treatment by self‐assembling peptides P11‐4 at baseline and will be followed up at 3 months, 6 months and 1 year using the above‐mentioned measurements. Group B: Topical Fluoride Varnish (Duraphat Varnish containing 22,600ppm fluoride, Colgate‐Palmolive, USA) 1) Twenty two teeth will receive treatment by topical fluoride varnish at Day 0 and will be followed up after 3 months, 6 months and 1 year using the above‐mentioned measurements. The assessment of the baseline and follow up data will be performed by the main investigator. Assessment will be done at baseline using the ICDAS II and Light Induced Fluorescence using Soprolife System (Acteon, La Ciotat, France) and then at 3 months, 6 months and 1 year.