Despite advancements in preventative oral care in the past few decades, caries is still the most prevalent non-communicable disease worldwide (Petersen et al, 2005). While one major reason is the increase in consumption of sugary, acidic, and ultra-processed foods, another is the lack of early intervention in the caries disease process.
Managing carious lesions in their early stages, when they are still non-cavitated and largely asymptomatic, is a significant step in tackling this disease, especially in the paediatric population.
CurodontRepair, by vVARDIS Switzerland, offers today a regenerative and non-invasive treatment for these incipient stages of caries. This revolutionary product based on the biomimetic self-assembling peptide technology is a patented, low-viscosity liquid formula that has the ability to diffuse to the depth of the caries lesion.
By utilising calcium and phosphate ions from the patient’s own saliva de novo hydroxyapatite crystals are generated, a process termed ‘guided enamel regeneration’ (Kind et al, 2017).
Clinical evidence
The efficacy of Curodont Repair has repeatedly been proven in several studies, including randomised controlled clinical trials. It has shown a clinical success rate above 90% defined as arrest and regression of initial caries lesions through in-depth enamel regeneration and it has proven to be significantly superior compared to fluoride varnish alone.
Recently, a retrospective analysis of non-cavitated proximal lesions treated with Curodont Repair in a public paediatric practice in Chur, Switzerland, was published in the Journal of American Dental Association (Godenzi et al, 2023). A total of 405 early interproximal carious lesions in 219 patients (age: 10-19 years) were treated with a single application of Curodont Repair and followed up with a once-a-week application of Curodont Protect.
Curodont Protect is a complement to Curodont Repair, containing the same peptide technology in a gel form and enriched with calcium, phosphate, and fluoride.
Patient follow-ups ranged from up to one year to up to six years. On analysis of pre-operative and follow-up bite-wing X-rays, a successful clinical outcome at the last follow-up, ie arrest or caries regression, was seen in 93% of the treated lesions. In the cases with follow-ups of more than two years, there was no cavitation in over 90% of lesions. An interesting observation was that the rate of regression did not depend on the initial depth of the carious lesion ie regression was even observed in lesions reaching the outer one-third of dentine.
Advantages for children
There are several advantages of treatment with CurodontRepair, making it ideal for use in the paediatric population:
It is applied in a single, short, drill-free, in-office procedure that does not require administration of anaesthesia or necessitate the use of a rubber dam
The formula is non-staining, tasteless
Typically, a single application is enough. In patients with a high caries risk, such as those with rampant caries or those undergoing fixed orthodontic treatment, the application can be repeated if necessary.
Paediatric dentists go many steps further than simply performing dental procedures to elicit good behaviour and condition positive responses in young patients. Non-invasive caries management with Curodont Repair is an invaluable tool in helping children have a positive experience in the dental clinic and shape their outlook for a lifetime.
Treatment with Curodont Repair is also relevant in the management of children and adolescents with special needs, including those with physical/learning disabilities. This vulnerable section of the population may face challenges with practicing routine oral hygiene independently. While treating such patients in the dental clinic, behaviour modulation is a challenge, with one often having to resort to sedation or general anaesthesia.
The importance of a strict regimen of regular dental visits and the judicious use of diagnostics is especially high. The use of Curodont Repair for the non-invasive management of any developing carious lesions in the enamel can help prevent painful and distressing situations in future.
The WHO Global oral health status report (2022) states that an estimated two billion people suffer from caries of permanent teeth and 514 million children suffer from caries of primary teeth. Along with educating patients on better oral hygiene practices, early intervention into the caries disease process with Curodont Repair has the potential to transform oral health and reduce this massive caries burden.
References
Petersen PE et al. Bull World Health Organ. 2005;83:661-9
Kind L et al. J Dent Res 2017 ; 96:790-797
Godenzi D et al. J Am Dent Assoc. 2023:S0002-8177(23)00416-6
