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“Filling without drilling”: A new class of product for the treatment of early stage dental decay based on hydrogels of self-assembling peptide tapes.

This new regenerative therapy for the treatment of early enamel decay developed from an interdisciplinary, collaborative research programme at Leeds led by the School of Chemistry's Crystallization and Direct Assembly Group, and the Leeds Dental Institute

Summary of the impact
A new class of synthetic self-assembling peptides has been developed at Leeds into a product that allows the enamel in the dental cavities to be regenerated. The peptides assemble to form gels that have been shown to be promising biocompatible materials with applications in regenerative medicine, for example in the regeneration of bone. Credentis AG (Switzerland) was founded in January 2010 to commercialise the technology in the dental care domain. Its first product Curodont™ Repair - the first product of its kind in dental care – has completed first-in-man safety trials (also at Leeds); has received regulatory approval for clinical use in Switzerland, Europe and Australia; and was launched in Switzerland and Germany in Q1/2013. The product has tremendous promise because most adults suffer from dental caries which often go untreated because of patients’ fear of the dental drill. A second product Curodont™ Protect, approved in April 2013 and regulated as a cosmetic, has been launched in 2013 for the treatment of dentin hypersensitivity. Credentis has established a UK base and has engaged a UK company as distributor of its products.

Details of the impact
Context: Dental decay is the most common of all diseases (prevalence is ~10% of the population of the western world p.a. i.e. 100 million lesions per year), yet the principles of treatment have remained unchanged for almost 100 years (J. Dent. 2003, 31, 395-405). Most adults worldwide suffer from dental caries (tooth decay), many of which go untreated because of patients’ fear of the dental drill. The earliest sign of tooth decay is the “white spot” lesion, visible to the clinician on the tooth surface. There is no current consensus view regarding treatment, and clinicians have three choices: (1) to monitor the lesion, and then to excavate and fill; (2) to apply fluoride treatments, and then to proceed as in (1); and (3) to place a small restoration. Ultimately, all restorations will fail and need to be replaced with larger fillings, and will eventually lead to tooth loss and replacement. Treatment currently costs the UK NHS ca £2bn pa (roughly half of the budget for dental care; Office of the Government Auditor). Drilling is feared by many patients, inhibiting their attendance at the dentist and so precluding opportunities for early diagnosis and treatment of decay as well as diseases such as oral cancer. Leeds’ self-assembling peptide technology provides a simple and cost-effective alternative to current treatments that avoids a subsequent need for larger fillings; this technology removes the clinician’s dilemma of whether to treat decay, and removes the need for drilling and thus the fear of visiting the dentist. The novel technology has received significant attention in the media.