A new frontier in oral care with proteins and peptide infused in orally disintegrating film to prevent early dental erosion in vivo

OBJECTIVE: This study investigated the effectiveness of orally disintegrating films (ODFs) formulated with different proteins and peptide in minimizing early-stage dental erosion in vivo. METHODS: Twelve individuals participated in a six-phase crossover: placebo, 1 mg sodium fluoride (NaF), 1 mg sugarcane-derived cystatin (CaneCPI-5), 5 mg maquiberry-derived cystatin (MaquiCPI-3), 1 mg orange-derived cystatin (CsinCPI-2), and 0.37 mg statherin peptide (StN15pSpS). Following prophylaxis, participants placed the ODFs on their tongues until they dissolved, after the acquired pellicle was allowed to form over 2 h. An erosive challenge (biopsy, 1 % citric acid, 15 s) was conducted on the labial surface of the maxillary central incisors. Enamel loss was assessed using Relative Surface Reflection Intensity (%SRI), and calcium release in citric acid was measured using Arsenazo-III. Data were analyzed using Kruskal-Wallis and Dunn's post hoc tests (p < 0.05). A questionnaire assessed participants' satisfaction and any side effects. RESULTS: The %SRI results demonstrated that MaquiCPI-3, CaneCPI-5, StN15pSpS, and NaF provided significantly greater enamel protection compared to the placebo (p < 0.05). Calcium analysis showed that the ODFs containing CaneCPI-5 and MaquiCPI-3 resulted in similarly high calcium levels, whereas the placebo and NaF groups exhibited the lowest values, with no difference between them. The CsinCPI-2 and StN15pSpS groups displayed intermediate effects, with no significant differences compared to the other groups, except for CsinCPI-2, which presented significantly reduced calcium levels compared to the MaquiCPI-3 group (p < 0.05). Participants reported satisfaction with the taste of the ODFs, found the procedures acceptable, and noted no adverse effects. CONCLUSIONS: ODFs containing MaquiCPI-3, CaneCPI-5, and StN15pSpS effectively inhibited early dental erosion according to %SRI. CLINICAL SIGNIFICANCE: These findings highlight the potential of ODFs as innovative delivery systems for organic compounds aimed at preventing erosive tooth wear and promoting oral health.