The virulence of Streptococcus mutans and the ability to form biofilms

Effect of bioactive compounds on the regulation of quorum sensing network-associated genes and virulence in Streptococcus mutans-A systematic review

OBJECTIVE

The aim of this study was to systematically review the literature on the effect of bioactive compounds and their regulation of quorum sensing (QS)-related and/or -regulated-virulence genes expression in Streptococcus mutans.

DESIGN

The search strategy was conducted through the electronic databases Pubmed, Scopus, and Web of Science for studies reporting the effects of natural and synthetic bioactive compounds on the regulation of QS-associated and/or -regulated genes of S. mutans.

RESULTS

After full-text reading, 19 studies met the inclusion criteria, in most of them, QS-inhibitors from synthetic origin were evaluated, 16 articles described the effect of the compounds on biofilm formation cultivated in vitro and five studies described these effects on adhesion of biofilm-producing cells. Only 2 studies analyzed the potential target-component of the QS.

CONCLUSIONS

Mostly, the bioactive compounds affected the expression of QS-associated and/or -regulated genes and virulence traits (e.g. adhesion, biofilm formation, acid stress tolerance) of S. mutans. Further studies are necessary to elucidate the target-specific QS-system constituent used by bioactive compounds to achieve QS inhibition as well as validate the use of these compounds in controlling dental caries.

Differences in Sweet Taste Perception and Its Association with the Streptococcus mutans Cariogenic Profile in Preschool Children with Caries

The aim of the study was to verify the hypothesis about differences in sweet taste perception in the group of preschool children with and without caries, and to determine its relationship with cariogenic microbiota and the frequency of sweets consumption in children. The study group included of 63 children aged 2–6 years: 32 with caries and 31 without caries. The study consisted of collecting questionnaire data and assessment of dental status using the decayed, missing, filled in primary teeth index (dmft) and the International Caries Detection and Assessment System (ICDAS II). The evaluation of sweet taste perception was carried out using a specific method that simultaneously assessed the level of taste preferences and the sensitivity threshold for a given taste. The microbiological analysis consisted of the assessment of the quantitative and qualitative compositions of the oral microbiota of the examined children. The sweet taste perception of children with caries was characterized by a lower susceptibility to sucrose (the preferred sucrose solution concentration was >4 g/L) compared to children without caries (in the range ≤ 4 g/L, p = 0.0015, chi-square test). A similar relationship was also observed for frequent snacking between meals (p = 0.0038, chi-square test). The analysis of studied variables showed the existence of a strong positive correlation between the perception of sweet taste and the occurrence and intensity of the cariogenic process (p = 0.007 for dmft; and p = 0.012 for ICDAS II), as well as the frequency of consuming sweets (p ≤ 0.001 for frequent and repeated consumption of sweets during the day, Spearman test) in children with caries. Additionally, children with an elevated sucrose taste threshold were more than 10-times more likely to develop S. mutans presence (OR = 10.21; 95% CI 3.11–33.44). The results of this study suggest the future use of taste preferences in children as a diagnostic tool for the early detection of increased susceptibility to caries through microbial dysbiosis towards specific species of microorganisms.

Antibacterial Effect of Caffeic Acid Phenethyl Ester on Cariogenic Bacteria and Streptococcus mutans Biofilms

Dental caries is the most common disease in the human mouth. Streptococcus mutans is the primary cariogenic bacterium. Propolis is a nontoxic natural product with a strong inhibitory effect on oral cariogenic bacteria. The polyphenol-rich extract from propolis inhibits S. mutans growth and biofilm formation, as well as the genes involved in virulence and adherence, through the inhibition of glucosyltransferases (GTF). However, because the chemical composition of propolis is highly variable and complex, the mechanism of its antimicrobial action and the active compound are controversial and not completely understood. Caffeic acid phenethyl ester (CAPE) is abundant in the polyphenolic compounds from propolis, and it has many pharmacological effects. In this study, we investigated the antibacterial effects of CAPE on common oral cariogenic bacteria (Streptococcus mutans, Streptococcus sobrinus, Actinomyces viscosus, and Lactobacillus acidophilus) and its effects on the biofilm-forming and cariogenic abilities of S. mutans CAPE shows remarkable antimicrobial activity against cariogenic bacteria. Moreover, CAPE also inhibits the formation of S. mutans biofilms and their metabolic activity in mature biofilms. Furthermore, CAPE can inhibit the key virulence factors of S. mutans associated with cariogenicity, including acid production, acid tolerance, and the bacterium's ability to produce extracellular polysaccharides (EPS), without affecting bacterial viability at subinhibitory levels. In conclusion, CAPE appears to be a new agent with anticariogenic potential, not only via inhibition of the growth of cariogenic bacteria.

Electronic cigarette vapor increases Streptococcus mutans growth, adhesion, biofilm formation, and expression of the biofilm-associated genes

OBJECTIVE

It still not known whether electronic cigarettes (e-cigarettes) contribute to dental caries. This study aimed to evaluate the effect of e-cigarettes on the growth of Streptococcus mutans, the formation of biofilm, and the expression of certain virulence genes.

MATERIALS AND METHODS

Streptococcus mutans cells were exposed or not to e-cigarettes with and without nicotine or to cigarette smoke twice a day for 15 min each exposure period. The bacterial growth and the expression of glucosyltranferase, competence, and glucan-binding genes were evaluated after 24 hr. Biofilm formation was assessed after 1, 2, and 3 days. S. mutans adhesion and growth to e-cigarette exposed human teeth were assessed.

RESULTS

We observed an increase in S. mutans growth with e-cigarettes, mainly at the early culture period. This was confirmed by an increase of biofilm mass ranging from 8 ± 0.5 mg with the control to 47 ± 5 mg after six exposures to nicotine-rich e-cigarettes. S. mutans cells adhered better to e-cigarette exposed teeth. E-cigarettes increased the expression of glucosyltranferase, competence, and glucan-binding genes.

CONCLUSIONS

E-cigarettes increased the growth of S. mutans and the expression of virulent genes. E-cigarettes promoted the adhesion to, and formation of biofilms on teeth surfaces.

In vitro evaluation of composite containing DMAHDM and calcium phosphate nanoparticles on recurrent caries inhibition at bovine enamel-restoration margins

OBJECTIVE

Recurrent caries is a primary reason for restoration failure caused by biofilm acids. The objectives of this study were to: (1) develop a novel multifunctional composite with antibacterial function and calcium (Ca) and phosphate (P) ion release, and (2) investigate the effects on enamel demineralization and hardness at the margins under biofilms.

METHODS

Dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP) were incorporated into composite. Four groups were tested: (1) Commercial control (Heliomolar), (2) Experimental control (0% DMAHDM + 0% NACP), (3) antibacterial group (3% DMAHDM + 0% NACP), (D) antibacterial and remineralizing group (3% DMAHDM + 30% NACP). Mechanical properties and Ca and P ion release were measured. Colony-forming units (CFU), lactic acid and polysaccharide of Streptococcus mutans (S. mutans) biofilms were evaluated. Demineralization of bovine enamel with restorations was induced via S. mutans, and enamel hardness was measured. Data were analyzed via one-way and two-way analyses of variance and Tukey's multiple comparison tests.

RESULTS

Adding DMAHDM and NACP into composite did not compromise the mechanical properties (P > 0.05). Ca and P ion release of 3% DMAHDM + 30% NACP was increased at cariogenic low pH. Biofilm lactic acid and polysaccharides were greatly decreased via DMAHDM, and CFU was reduced by 4 logs (P < 0.05). Under biofilm acids, enamel hardness at the margins was decreased to about 0.5 GPa for control; it was about 1 GPa for antibacterial group, and 1.3 GPa for antibacterial and remineralizing group (P < 0.05).

CONCLUSIONS

The novel 3% DMAHDM + 30% NACP composite had strong antibacterial effects. It substantially reduced enamel demineralization adjacent to restorations under biofilm acid attacks, yielding enamel hardness that was 2-fold greater than that of control composites. The novel multifunctional composite is promising to inhibit recurrent caries.

An Ayurvedic Herbal Extract Inhibits Streptococcus mutans Biofilm Formation and Disrupts Preformed Biofilms in vitro

OBJECTIVE

Sudantha® (SUD), a natural proprietary mixture of herbal extracts that has been incorporated into toothpaste, has been shown in two separate placebo controlled human clinical studies to promote gingival health; and reduce gingival bleeding and plaque formation. However, the herbal based anti-gingivitis mechanisms of Sudantha are not fully understood. The objective of this study was to determine the effect of Sudantha on dental plaque biofilms by investigating its effect on mono-culture biofilms of a primary colonizer, Streptococcus mutans, in vitro.

RESULTS

This study found that SUD contributes to the maintenance of oral health through the inhibition of S. mutans biofilm formation. In addition, SUD disrupted preformed S. mutans biofilms after exposure to SUD for 4 hours. Together, this pilot data suggests the inhibition of S. mutans biofilm formation and disruption represents one potential mechanism by which the herbal extract is able to reduce the oral bacterial biofilm resulting in its effective against gingivitis and its potential use in countering biofilm associated oral disease.

Guardian genes ensuring subsistence of oral Streptococcus mutans

Despite the substantial research advancements on oral diseases, dental caries remains a major healthcare burden. A disease of microbial dysbiosis, dental caries is characterised by the formation of biofilms that assist demineralisation and destruction of the dental hard tissues. While it is well understood that this is a multi-kingdom biofilm-mediated disease, it has been elucidated that acid producing and acid tolerant bacteria play pioneering roles in the process. Specifically, Streptococcus mutans houses major virulence pathways that enable it to thrive in the oral cavity and cause caries. This pathogen adheres to the tooth substrate, forms biofilms, resists external stress, produces acids, kills closely related species, and survives the acid as well as the host clearance mechanisms. For an organism to be able to confer such virulence, it requires a large and complex gene network which synergise to establish disease. In this review, we have charted how these multi-faceted genes control several caries-related functions of Streptococcus mutans. In a futuristic thinking approach, we also briefly discuss the potential roles of omics and machine learning, to ease the study of non-functional genes that may play a major role and enable the integration of experimental data.

Evaluation of total phenol and flavonoid content and antimicrobial and antibiofilm activities of Trollius chinensis Bunge extracts on Streptococcus mutans

Dental caries is a chronic disease with multiple bacterial infections, Streptococcus mutans is the main cariogenic bacteria. Trollius chinensis Bunge is a common folk medicine in the Xinjiang area of China. In this study, we investigated the total flavonoid content and total phenol content in four types of T. chinensis Bunge extracts and the inhibitory effects of these extracts on S. mutans. Agar diffusion method was used to measure the inhibition zone diameters, and the minimum inhibitory concentration and minimum bactericidal concentration were determined by the twofold dilution method. Water extracts from T. chinensis Bunge and ethanol (30, 60, and 90%) extracts at different concentrations could significantly inhibit the growth of S. mutans. Among them, 30% ethanol extract exhibited the best antibacterial and antibiofilms effect. Biofilm research (crystal violet staining and CLSM) showed that 30% ethanol extract of T. chinensis Bunge plays an important role in inhibiting S. mutans growth and the number of biofilms. The results indicate that T. chinensis Bunge extract has good antibacterial and anti-biofilm activity on S. mutans. It has the potential to be developed for the treatment of caries in clinical application.

Utilization of the extract of Cedrus deodara (Roxb. ex D.Don) G. Don against the biofilm formation and the expression of virulence genes of cariogenic bacterium Streptococcus mutans

ETHNOPHARMACOLOGICAL RELEVANCE

Cedrus deodara (Roxb. ex D.Don) G. Don is applied as anti-inflammatory and anti-infection agents in folklore medicine.

AIM OF THE STUDY

The present study aimed to assess the antimicrobial activity of Cedrus deodara (Roxb. ex D.Don) G. Don extract (CDE) against Streptococcus mutans biofilm formation and its biocompatibility, as well as to identify its chemical components.

MATERIALS AND METHODS

Confocal laser scanning microscopy (CLSM), crystal violet staining, and CFU counting assay were applied to investigate the effect of CDE on S. mutans biofilm formation and extracellular polysaccharides (EPS) synthesis. The microstructure of S. mutans biofilms formed on glass coverslips and bovine enamel treated with CDE was observed by scanning electron microscopy (SEM). qRT-PCR was used to measure the expression of virulence genes gtfB, gtfC, and gtfD, and zymogram assay was performed to investigate the enzymatic activity of Gtfs. Moreover, HPLC-MS and NMR were applied to identify its chemical components. CCK-8 assay was also performed on human oral cells to evaluate its biocompatibility.

RESULTS

Under the treatment of CDE, S. mutans formed less biofilm on both coverslips and enamel surfaces and synthesized less EPS. Moreover, CDE downregulated the expression of gtf genes and inhibited the enzymatic activity of Gtfs. According to HPLC-MS and NMR results, molecular structures of six main compounds in CDE were identified. CDE also has a good biocompatibility.

CONCLUSIONS

CDE exhibits inhibitory activity against S. mutans and a good biocompatibility. It has the potential to be developed as anti-caries agents for clinical use.

Interspecies Interactions Between Streptococcus Mutans and Streptococcus Agalactiae in vitro

Streptococcus mutans is an oral species closely associated with dental caries. As an early oral colonizer, S. mutans utilizes interspecies coaggregation to promote the colonization of subsequent species and affect polymicrobial pathogenesis. Previous studies have confirmed several adhering partner species of S. mutans, including Candida albicans and Fusobacterium nucleatum. In this study, we discovered new intergeneric co-adherence between S. mutans and the saliva isolate Streptococcus agalactiae (GBS-SI101). Research shows that GBS typically colonizes the human gastrointestinal and vaginal tracts. It is responsible for adverse pregnancy outcomes and life-threatening infections in neonates and immunocompromised people. Our results revealed that GtfB and GtfC of S. mutans, which contributed to extracellular polysaccharide synthesis, promoted coaggregation of S. mutans with GBS-SI101. In addition, oral streptococci, including Streptococcus sanguinis, Streptococcus gordonii and S. mutans, barely inhibited the growth of GBS-SI101. This study indicated that S. mutans could help GBS integrate into the Streptococcus-associated oral polymicrobial community and become a resident species in the oral cavity, increasing the risk of oral infections.

The forming of bacteria biofilm from Streptococcus mutans and Aggregatibacter actinomycetemcomitans as a marker for early detection in dental caries and periodontitis

Background

This is an initial study of the biofilm of Streptococcus mutans (S.mutans) and Aggregatibacter actinomycetemcomitans (A.a). S. mutans and A.aare bacteria that cause infection diseases in the oral cavity. These bacteria have the ability to form biofilms. The study of bacterial biofilm proteins was used as an alternative to early prevention for oral infections. It would be used for the purpose of creating a marker for Infection Detection Kit in the oral cavity.

Objective

To easily detect caries or Periodontitis with the biofilms of S. mutans and A.a at the early stage. The forming of biofilm proteins from S.mutans and A.a induced with 5% glucose, 5% lactose, 5% soy protein, and 5% iron will be use as a marker for early detection to Dental caries and Periodontitis.

Methods

SDS-PAGE electrophoresis technique was used in the study to measure the molecular weight of S. mutans and A.a biofilms induced with 5% glucose, 5% lactose, 5% soy protein, and 5% iron.

Results

Biofilm bands of S. mutans and A.a were formed with the various numbers depending on the induction used. These results are early chararterization of biofilm that will beused as a marker for early detection of infectious diseases in oral cavity (Dental Caries and Periodontitis).

Conclusions: S. mutans

bacteria induced with 5% glucose had one band of biofilm protein, with 5% lactose had four bands of biofilm proteins, and with soy protein had seven bands of biofilm protein, but with 5% iron did not produce any protein bands and neither did A.a.

Small noncoding RNA sRNA0426 is involved in regulating biofilm formation in Streptococcus mutans

Evidence suggests that small noncoding RNAs (sRNAs) are involved in the complex regulatory networks governing biofilm formation. Few studies have investigated the role of sRNAs in Streptococcus mutans (S. mutans). In the present study, the association between sRNA and biofilm formation in S. mutans was explored. sRNAs that are differentially expressed in the biofilm and planktonic states of this bacterium were identified by quantitative real‐time PCR (qRT‐PCR). Confocal laser scanning microscopy was used to investigate the characteristics of biofilm formation in a standard strain of S. mutans (UA159, ATCC 700610) and ten clinical strains. Bioinformatics analyses were employed to predict and examine potential sRNA regulatory pathways. The results showed that sRNA0426 has a strong positive relationship with dynamic biofilm formation. Moreover, sRNA0426 expression was positively correlated with exopolysaccharide (EPS) production. Bioinformatics analyses showed that sRNA0426 is involved in biofilm formation such as metabolic pathways, especially carbon metabolism. Five target mRNAs (GtfB, GtfC, GtfD, ComE, and CcpA) involved in the synthesis of EPS were selected for further evaluation; the expression levels of three of these mRNAs (GtfB, GtfC, and CcpA) were positively correlated with sRNA0426 expression levels, and the expression level of one (ComE) was negatively correlated. In conclusion, the results suggested that sRNA0426 may play an important and positive role in the biofilm formation of S. mutans and provide novel insight into the S. mutans biofilm regulatory network.

Biochemical and microbiological analysis of the saliva of institutionalized elderly: With edentulism, use of dentures and presence of biofilm

BACKGROUND

To analyze biochemical and microbiological parameters of the saliva of institutionalized elders and to investigate the relation of these parameters with edentulism, use of dentures and presence of biofilm.

MATERIAL AND METHODS

A cross-sectional study carried was out in seven long-term institutions. Samples (n=161) of unstimulated saliva were collected for analysis of salivary flow, quantification of total proteins and identification of microorganisms. Oral examination was carried out to verify the number of missing teeth, the use of dentures and the presence of visible biofilm on the surface of teeth and dentures. Associations were performed using chi-square or Fisher's exact test (α<0.05). Mann-Whitney Test was used to identify differences in the salivary flow and total proteins (α<0.05).

RESULTS

There was no association between the type of edentulism and use of dentures with biochemical and microbiological parameters of saliva (p>0.05). Associations were observed between the presence of dentures biofilm and the colonization of Streptococcus sp. (p=0.038) and Candida sp. (p=0.03).

CONCLUSIONS

The absence of teeth and use of dentures do not influence the amount of total proteins and the microorganisms count in saliva. Denture biofilms are associated with the presence of Streptococcus sp. and Candida sp. in saliva of institutionalized elders. Key words:Candida, long-stay institutions for elders, saliva, Streptococcus, Staphylococcus.

Antimicrobial effect of anacardic acid-loaded zein nanoparticles loaded on Streptococcus mutans biofilms

Bacterial biofilms play a key role in the pathogenesis of major oral diseases. Nanoparticles open new paths for drug delivery in complex structures such as biofilms. This study evaluated the antimicrobial effect of zein nanoparticles containing anacardic acid (AA) extracted from cashew shells of Anacardium occidentale on in vitro Streptococcus mutans biofilm formation and mature biofilms. The minimum inhibitory concentration (MIC), minimum bacterial concentration (MBC), and antibiofilm assays were performed. Streptococcus mutans UA159 biofilms were formed on saliva-coated hydroxyapatite disk for 5 days. To evaluate the preventive effect on biofilm formation, before contact with the inoculum, the disks were immersed once for 2 min in (1) hydroethanolic solution; (2) blank zein nanoparticles; (3) zein nanoparticles containing AA; and (4) 0.12% chlorhexidine gluconate. To determine the effect against mature biofilms, the disks containing 5-day preformed biofilms were further treated using the same procedure. The bacterial viability and dry weight were determined for both assays and used to compare the groups using ANOVA followed by Tukey's test (p < 0.05). Both MIC and MBC for AA-loaded zein nanoparticles were 0.36 μg/mL. Groups 3 and 4 were very effective in inhibiting S. mutans biofilm formation, as no colony-forming units were detected. In contrast, for mature biofilms, no difference in bacterial viability (p = 0.28) or dry weight (p = 0.09) was found between the treatments. Therefore, the AA-based nanoformulation presented very high inhibitory and bactericidal activities against planktonic S. mutans, and the results indicate a strong antiplaque effect. However, the formulation showed no antimicrobial effect on the established biofilm.

Development of polycationic micelles as an efficient delivery system of antibiotics for overcoming the biological barriers to reverse multidrug resistance in Escherichia coli

Highly pathogenic Gram-negative bacteria (G-) are tenacious and pose a serious threat to public health, mainly because of three biological barriers: cell envelope blockages, biofilm protection, and macrophages shelter. One strategy to bypass the biological barriers and consequently achieve a satisfying G- bactericidal effect is to utilize polymeric micelles with superior bacterial recognition and binding capabilities. In the current study, we explored the biological barriers penetration ability of a traditional polycationic micellar system (PP-PEI) based on a copolymer of polylactide-poly (ethylene glycol)-polyethylenimine (PLA5K-PEG2K-PEI2K). Subsequently, tetracycline (TC) with good fluorescence property was encapsulated into the PLA core of the micelle (PP-PEI/TC) through hydrophobic interaction. The combination of a PEI shell and loaded antibiotic drug endowed the polycationic micelles with a greater capacity for killing drug-resistant bacteria, destructing biofilms, and eradicating intracellular bacteria, compared with free TC and micelles without the inoculation of a PEI moiety. Confocal laser scanning microscopy (CLSM) and flow cytometry illustrated that PP-PEI/TC could completely penetrate and accumulate in drug-resistant E. coli, biofilms, and infected macrophages. The efficient biological barrier penetration was elucidated as due to the strong electrostatic interactions between the polycationic PEI block and the anionic composition of the bacterial outer membrane (e.g., LPS), macrophage cell membrane (e.g., phospholipid), and extracellular polymeric substances (e.g., eDNA), which was confirmed by biolayer interferometry (BLI). Once the micellar system was bound to a negatively-charged surface, bacterial and cellular enzymes could degrade the PP-PEI core to release its antibacterial content and finally kill planktonic bacteria, bacteria over the depth of a biofilm, and/or intracellular bacteria. In vivo imaging indicated that fluorescent polycationic micelles accumulated in bacterial infection sites with strong fluorescence. In vivo antibacterial experiments showed that PP-PEI/TC could dramatically reduce the number of drug-resistant E. coli EB1-1 in the peritoneal cavity of acute peritonitis BALB/c mice compared with its counterparts. In conclusion, our study demonstrated that polycationic micelles with a PEI shell could penetrate into drug-resistant bacteria, the biofilm matrix, and infected macrophages and lead to the spatiotemporal release of antibacterial agents for the comprehensive treatment of drug-resistant relevant infections.

Pyruvate secretion by oral streptococci modulates hydrogen peroxide dependent antagonism

Many commensal oral streptococci generate H₂O₂ via pyruvate oxidase (SpxB) to inhibit the growth of competing bacteria like Streptococcus mutans, a major cariogenic species. In Streptococcus sanguinis SK36 (SK36) and Streptococcus gordonii DL1 (DL1), spxB expression and H₂O₂ release are subject to carbon catabolite repression by the catabolite control protein A (CcpA). Surprisingly, ccpA deletion mutants of SK36 and DL1 fail to inhibit S. mutans despite their production of otherwise inhibitory levels of H₂O₂. Using H₂O₂-deficient spxB deletion mutants of SK36 and DL1, it was subsequently discovered that both strains confer protection in trans to other bacteria when H₂O₂ is added exogenously. This protective effect depends on the direct detoxification of H₂O₂ by the release of pyruvate. The pyruvate dependent protective effect is also present in other spxB-encoding streptococci, such as the pneumococcus, but is missing from spxB-negative species like S. mutans. Targeted and transposon-based mutagenesis revealed Nox (putative H₂O-forming NADH dehydrogenase) as an essential component required for pyruvate release and oxidative protection, while other genes such as sodA and dps play minor roles. Furthermore, pyruvate secretion is only detectable in aerobic growth conditions at biofilm-like cell densities and is responsive to CcpA-dependent catabolite control. This ability of spxB-encoding streptococci reveals a new facet of the competitive interactions between oral commensals and pathobionts and provides a mechanistic basis for the variable levels of inhibitory potential observed among H₂O₂-producing strains of commensal oral streptococci.

Indonesian Mangosteen Fruit (Garcinia mangostana L.) Peel Extract Inhibits Streptococcus mutans and Porphyromonas gingivalis in Biofilms In vitro

Background:

Streptococcus mutans and Porphyromonas gingivalis are caries and periodontal disease-related bacteria. The mangosteen fruit (Garcinia mangostana L.) peel contains flavonoids, tannins, saponins, and xanthones that have antibacterial properties.

Aims:

The aim of this study is to analyze mangosteen peel extracts’ ability to inhibit S. mutans and P. gingivalis has biofilms growth in vitro.

Materials and Methods:

Mangosteen peel extract effects on the S. mutans ATCC-3198 and P. gingivalis ATCC-3327 in biofilms growth were evaluated by a crystal violet biofilm assay. Each bacterium was inoculated into a brain–heart infusion broth for 24 h at 37°C anaerobic conditions. A volume of 200 μL (10⁷ colony-forming unit/mL) of bacterial suspension were distributed in microplate wells and incubated for 24 h. Mangosteen peel extracts with different concentrations were added into biofilm wells. Biofilm without treatment was used as negative control. Biofilm mass was calculated by 0.5% crystal violet staining, and optical density was measured at 600 nm using microplate reader. All obtained data were statistically analyzed using one-way analysis of variance test with P < 0.05 set as the level of significance.

Results:

The results showed that mangosteen peel extract could inhibit the growth of S. mutans and P. gingivalis in biofilms significantly compared to the negative control (P < 0.05). The most effective concentration and incubation time for inhibiting biofilm growth was 100% in 6 h for S. mutans and 100% in 24 h for P. gingivalis.

Conclusion:

Mangosteen peel extract is effective at inhibiting S. mutans and P. gingivalis biofilms, and this antibiofilm agent can be an alternative therapy in preventing caries and periodontal disease. Future studies are needed to explore this effect.

Effects of the natural compound, oxyresveratrol, on the growth of Streptococcus mutans, and on biofilm formation, acid production, and virulence gene expression

Streptococcus mutans is one of the major pathogens of dental caries. Oxyresveratrol, a natural compound found in plants, exerts inhibitory effects on many bacterial species but its effect on S. mutans is unknown. The objective of this study was to clarify the antibacterial effect of oxyresveratrol on S. mutans, including effects on basic viability, acidogenicity, acidurity, and extracellular polysaccharide synthesis. The expression of nine genes that encode virulence and protective factors in S. mutans was measured by qRT-PCR. Oxyresveratrol showed a dose-dependent inhibitory effect on survival of S. mutans. At 250 μg ml^-1 , oxyresveratrol reduced the S. mutans survival rate, inhibited synthesis of water-insoluble glucans, compromised biofilm formation, and significantly down-regulated the expression of glucosyltransferase-I (gtfB) and glucosyltransferase-SI (gtfC). However, the enzymatic activity of lactate dehydrogenase protein was increased and the expression of lactate dehydrogenase (ldh) and ATP synthase subunit beta (atpD) genes were also up-regulated. Besides, glucosyltransferase S (gtfD) up-regulation indicated that water-soluble glucan synthesis was promoted. The vicR, liaR, and comDE genes, which exert a self-protective function in response to external stress, were also up-regulated. In conclusion, oxyresveratrol inhibited the growth of S. mutans and also reduced biofilm formation, acid production, and synthesis of water-insoluble glucans by this organism. In addition, oxyresveratrol also activated a series of S. mutans self-protection mechanisms.

A novel non-cytotoxic synthetic peptide, Pug-1, exhibited an antibiofilm effect on Streptococcus mutans adhesion

The aim of this study was to evaluate the effects of synthetic peptides on the growth and biofilm formation of Streptococcus mutans and their cytotoxicity on a human keratinocyte cell line. Four pomegranate-derived peptides; Pug-1, Pug-2, Pug-3 and Pug-4 were synthesized. Streptococcus mutans (ATCC 25175 and DMST 41283) were used. The antibacterial and anti-adherence activities of the peptides were evaluated. The effect of the peptides on S. mutans glucosyltransferase (Gtf) activity was measured. The peptides' cytotoxicity was evaluated on a HaCaT cell line using an MTT assay. The bactericidal penetration depth of Pug-1 into the biofilm was investigated using confocal laser scanning microscopy (CLSM). Among the four peptides, Pug-1 (200 µg ml^-1 ) exhibited antibacterial activity on S. mutans (DMST 41283). All peptides demonstrated anti-adherence activity. Streptococcus mutans Gtf activity was significantly inhibited by Pug-1. Interestingly, Pug-1 peptide was not cytotoxic to the HaCaT cell line. Pug-1 (100-200 µg ml^-1 ) exhibited bactericidal penetration at approximately 50-100% of the biofilm depth. Therefore, Pug-1 might be a candidate of anticariogenic agent. SIGNIFICANCE AND IMPACT OF THE STUDY: Our data highlighted that pomegranate-derived antimicrobial peptides (AMPs) inhibit Streptococcus mutans adhesion, virulence-associated genes and enzymes. This in vitro study supports the hypothesis that pomegranate AMPs would be noncytotoxic to human keratinocytes, with a potent anticariogenic effect via an anti-adherence mode-of-action. The present study provides evidence for further investigation of these AMPs as therapeutic and preventive agents for dental caries.

Signaling Natural Products from Human Pathogenic Bacteria

Natural products from microorganisms are important small molecules that play roles in various biological processes like cellular growth, motility, nutrient acquisition, stress response, biofilm formation, and defense. It is hypothesized that pathogens exploit these molecules to regulate virulence and persistence during infections. Here, we present selected examples of signaling natural products from human pathogenic bacteria that use these metabolites to gain a competitive advantage. Targeting these signaling systems provides novel strategies to antimicrobial treatments.

Effects of Cariogenic Bacteria and Sealant Evaluated by International Caries Detection Assessment System

Aim:

Evaluation of tooth surface level effect of cariogenic bacteria and sealant.

Background:

International Caries Detection Assessment System (ICADS) is a clinical scoring system that can assess the non-cavitated early stage of dental caries by surface level. Scores used in ICDAS are ordinary and each tooth within one individual is not statistically independent.

Objective:

In this study, by applying mixed effect modeling, the effect of cariogenic bacteria and fissure sealant for tooth surface-level caries progression was analyzed.

Methods:

Ninety-eight patients who had been regularly visited the dental hospital for the regular check-ups were enrolled in this study. Among them, patients who visited at baseline, after one and two years, were included for the analysis. Fifty-two patients were dropped out. The study population consisted of 25 boys and 21girls and their mean ages were 9.3 +/- 2.1. Salivary levels of cariogenic bacteria were measured by qPCR. Mixed effect modeling with repeated measures was applied for the analysis.

Results:

Salivary levels ofS. mutansandLactobacilliwere affected by the progression of the ICDAS score. Maxillary teeth, molars and buccal and occlusal surfaces were tended to progress. Maxillary tooth, molar tooth and buccal, approximal, and occlusal surface were tended to be affected by both cariogenic bacteria.

Conclusion:

By applying mixed effect modeling, highly-detailed surface-level analysis can be available.

Effects of Ag/ZnO nanocomposite at sub-minimum inhibitory concentrations on virulence factors of Streptococcus mutans

OBJECTIVE

Streptococcus mutans (S. mutans), the main pathogen of dental caries, could be well killed by Ag/ZnO nanocomposite. However, effects on virulence factors remain to be elucidated. This study investigated effects of Ag/ZnO at sub-minimum inhibitory concentrations (sub-MICs) on virulence factors of S. mutans and related genes expressions.

DESIGN

Effects of Ag/ZnO on the growth of S. mutans was investigated by growth curves and MTT staining method. The influence of Ag/ZnO at sub-MICs on biofilm formation was measured by the crystal violet staining method and observed by a scanning electron microscopy. Adherence, cell-surface hydrophobicity, acidogenicity and extracellular polysaccharides (EPS) of S. mutans after treatment by Ag/ZnO at sub-MICs were also investigated. Virulence factors related genes expressions after treated by Ag/ZnO at 1/2 MIC was conducted by the quantitative real-time PCR (qRT-PCR) method.

RESULTS

Sub-MICs of Ag/ZnO exhibited a dose-dependent inhibition on the virulence factors of S. mutans. Specially, Ag/ZnO at 1/2 MIC decreased 69.00 % biofilm formation, 31.78 % sucrose-independent and 48.08 % sucrose-dependent adherence, 69.44 % cell-surface hydrophobicity and 72.45 % water-soluble and 90.60 % water-insoluble EPS. Furthermore, the expression of virulence factors related genes was significantly suppressed by Ag/ZnO at 1/2 MIC.

CONCLUSIONS

Ag/ZnO at sub-MICs inhibited multiple virulence factors of S. mutans through downregulating the related genes. Ag/ZnO nanocomposite could be used for prevention of dental caries at low dosage.

Clinical Trials with Herbal Products for the Prevention of Dental Caries and Their Quality: A Scoping Study

It is currently recognized that an injudicious strategy about caries in the last decades has been not only focusing of research mostly in children, but also the narrow focusing on fluoride, because despite sufficient availability of fluoride in water and oral healthcare products, caries levels escalate steadily as people get older and caries remain a main public health issue to be settled. In the last two decades the scientific community intensified efforts of exploring other products for caries prevention, herbal products being one of these approaches. Preliminary evidence indicated that clinical trials for caries prevention with herbal products are heterogeneous in design, quality and products evaluated, we therefore performed a scoping review intended to explore the main characteristics of such clinical trials. From an initial collection of 1986 unique papers from different literature databases, 56 articles satisfied the inclusion and exclusion criteria. The species investigated, dosage forms, study designs, duration of intervention, controls, endpoints, quality of reporting, and risk of bias are discussed. Of the trials reviewed here, 85.71% reported positive results but given the methodological flaws and biases affecting them, it is difficult to conclude on the efficacy of those products based on the studies published thus far.

Effects of S. mutans gene-modification and antibacterial calcium phosphate nanocomposite on secondary caries and marginal enamel hardness

Secondary caries at the restoration-tooth margins is a main reason for dental restoration failures. Gene-modification for Streptococcus mutans (S. mutans) and composites containing dimethylaminohexadecyl methacrylate (DMAHDMA) and nanoparticles of amorphous calcium phosphate (NACP) all have the potential to suppress bacterial acids and promote remineralization. However, there has been no report of their effects on marginal caries-inhibition and enamel hardness. The objective of this study was to investigate the effects of gene-modification and DMAHDM-NACP composite restoration on enamel demineralization and hardness at the margins under biofilm acids for the first time. Parent S. mutans and rnc gene-deleted S. mutans were tested side by side. The bioactive composite contained 3% DMAHDM and 30% NACP. Mechanical properties and calcium (Ca) and phosphate (P) ion releases were measured. Colony-forming units (CFU), MTT, lactic acid and polysaccharide of biofilms were evaluated. Demineralization of bovine enamel with composite restorations was induced via biofilms, then enamel hardness was measured. The dual strategy of combining rnc-deletion with DMAHDM+30NACP: (1) achieved the strongest biofilm-inhibition, with the greatest reduction in biofilm CFU by 6 logs; (2) decreased biofilm lactic acid and polysaccharide production by more than 80%; (3) achieved enamel hardness that was 140% higher than that of a commercial fluoride-releasing composite under 30 days of biofilm acids. Therefore, the novel dual approach of rnc gene-deletion and DMAHDM+NACP nanocomposite is promising to inhibit secondary caries at the margins and increase the longevity of tooth restorations.

Effects of S. mutans gene-modification and antibacterial monomer dimethylaminohexadecyl methacrylate on biofilm growth and acid production

OBJECTIVES

Antibacterial quaternary ammonium monomers (QAMs) are used in resins. The rnc gene in Streptococcus mutans (S. mutans) plays a key role in resisting antibiotics. The objectives of this study were to investigate for the first time: (1) the effects of rnc deletion on S. mutans biofilms and acid production; (2) the combined effects of rnc deletion with dimethylaminohexadecyl methacrylate (DMAHDM) on biofilm-inhibition efficacy.

METHODS

Parent S. mutans strain UA159 (ATCC 700610) and the rnc-deleted S. mutans were used. Bacterial growth, minimum inhibitory concentration (MIC), and minimal bactericidal concentration (MBC) were measured to analyze the bacterial susceptibility of the parent and rnc-deleted S. mutans against DMAHDM, with the gold-standard chlorhexidine (CHX) as control. Biofilm biomass, polysaccharide and lactic acid production were measured.

RESULTS

The drug-susceptibility of the rnc-deleted S. mutans to DMAHDM or CHX was 2-fold higher than parent S. mutans. The drug-susceptibility did not increase after 10 passages (p < 0.05). Deleting the rnc gene increased the biofilm susceptibility to DMAHDM or CHX by 2-fold. The rnc-deletion in S. mutans reduced biofilm biomass, polysaccharide and lactic acid production, even at no drugs. DMAHDM was nearly 40 % more potent than the gold-standard CHX. The combination of rnc deletion+DMAHDM treatment achieved the greatest reduction in biofilm biomass, polysaccharide synthesis, and lactic acid production.

SIGNIFICANCE

Gene modification by deleting the rnc in S. mutans reduced the biofilm growth and acid production, and the rnc deletion+DMAHDM method showed the greatest biofilm-inhibition efficacy, for the first time. The dual strategy of antibacterial monomer+bacterial gene modification shows great potential to control biofilms and inhibit caries.

Genome Investigation of a Cariogenic Pathogen with Implications in Cardiovascular Diseases

The proportion of people suffering from cardiovascular diseases has risen by 34% in the last 15 years in India. Cardiomyopathy is among the many forms of CVD s present. Infection of heart muscles is the suspected etiological agent for the same. Oral pathogens gaining entry into the bloodstream are responsible for such infections. Streptococcus mutans is an oral pathogen with implications in cardiovascular diseases. Previous studies have shown certain strains of S. mutans are found predominantly within atherosclerotic plaques and extirpated valves. To decipher the genetic differences responsible for endothelial cell invasion, we have sequenced the genome of Streptococcus mutans B14. Pan-genome analysis, search for adhesion proteins through a special algorithm, and protein-protein interactions search through HPIDB have been done. Pan-genome analysis of 187 whole genomes, assemblies revealed 6965 genes in total and 918 genes forming the core gene cluster. Adhesion to the endothelial cell is a critical virulence factor distinguishing virulent and non-virulent strains. Overall, 4% of the total proteins in S. mutans B14 were categorized as adhesion proteins. Protein-protein interaction between putative adhesion proteins and Human extracellular matrix components was predicted, revealing novel interactions. A conserved gene catalyzing the synthesis of branched-chain amino acids in S. mutans B14 shows possible interaction with isoforms of cathepsin protein of the ECM. This genome sequence analysis indicates towards other proteins in the S. mutans genome, which might have a specific role to play in host cell interaction.

Exposure of Streptococcus mutans and Streptococcus sanguinis to blue light in an oral biofilm model

The potential anti-cariogenic effect of blue light was evaluated using an oral biofilm model. Two species, Streptococcus mutans and Streptococcus sanguinis, were cultivated ex vivo on bovine enamel blocks for 24 h, either separately or mixed together, then exposed to blue light (wavelengths 400-500 nm) using 112 J/cm². Twenty four or 48 h after exposure to light the biofilm structure and biomass were characterized and quantified using SEM and qPCR, respectively. Bacterial viability was analyzed by CLSM using live/dead bacterial staining. Gene expression was examined by RT-qPCR. After exposure to light, S. mutans biomass in mono-species biofilm was increased mainly by dead bacteria, relative to control. However, the bacterial biomass of S. mutans when grown in mixed biofilm and of S. sanguinis in mono-species biofilm was reduced after light exposure, with no significant change in viability when compared to control. Furthermore, when grown separately, an upregulation of gene expression related to biofilm formation of S. mutans, and downregulation of similar genes of S. sanguinis, were measured 24 h after exposure to blue light. However, in mixed biofilm, a downregulation of those genes in both species was observed, although not significant in S. mutans. In conclusion, blue light seems to effectively alter the bacterial biomass by reducing the viability and virulence characteristics in both bacterial species and may promote the anti-cariogenic balance between them, when grown in a mixed biofilm. Therefore, exposure of oral biofilm to blue light has the potential to serve as a complementary approach in preventive dentistry.

Adhesion of biofilms on titanium measured by laser-induced spallation

Eradication of established implant-associated and bacterial biofilm-forming infections remains difficult in part because these biofilms remain well-adhered to the implant surface. Few experimental techniques are available to measure macro-scale strength of bacterial biofilm-implant adhesion. We have adapted the laser spallation technique to compare the macro-scale adhesion strength of biofilms formed on titanium. By using a rapid pressure wave (35 ns) to load the interface, we prevent disturbance of the biofilm surface prior to measurement, and preclude the time necessary for the biofilm to respond to and adapt under loading. Biofilms of Streptococcus mutans, a Gram-positive bacterium associated with human dental caries (cavities) were cultured directly on commercially pure titanium within our custom substrate assembly. Growth conditions were varied by adding sucrose to the Todd Hewitt Yeast (THY) broth: THY control, 37.5 mM, 75 mM, 375 mM, and 750 mM sucrose. Multiple locations on each biofilm were loaded using the laser spallation technique. Loading pressure wave amplitude was controlled by adjusting laser fluence, energy per area. Initially, addition of sucrose to the media increased biofilm adhesion to titanium. However, once a saturation concentration of 75 mM sucrose was reached, increasing the sucrose concentration further resulted in a decrease in biofilm adhesion. This study is the first demonstration of the adaptation of the laser spallation technique to measure bacterial biofilm adhesion. Establishment of this macro-scale biofilm adhesion measurement technique opens the door for many biofilm-surface adhesion studies. We anticipate further work in this area towards understanding the complex relationships among bacteria species, environmental factors, surface characteristics, and biofilm adhesion strength.

Effect of sesame oil, ozonated sesame oil, and chlorhexidine mouthwash on oral health status of adolescents: A randomized controlled pilot trial

CONTEXT

Oil pulling procedure involves swishing of oil in the mouth for various oral health benefits.

AIM

The aim of the study was to evaluate the effectiveness of sesame oil (SO), ozonated SO (OSO), and chlorhexidine (CHX) mouthwash on the oral health status of adolescents.

STUDY SETTINGS AND DESIGN

Parallel multi-arm double-blinded randomized trial was done in a Government higher secondary school.

MATERIALS AND METHODS

A total of 75 adolescents aged 12-14 years with decay-missing-filled index ≤3 were randomly assigned to three groups (n = 25): Group I (SO), Group II (OSO), and Group III (CHX mouthwash). Baseline (T1) Debris Index (DI-S), Calculus Index (CI-S), Oral Hygiene Index-Simplified (OHI-S), Plaque Index (PI), and salivary Streptococcus mutans count were recorded. All the groups were subjected to intervention with the respective mouth rinses for 15 days. The index scores and the salivary S. mutans count were reassessed after 15 days (T2) and 1 month (T3), and the results were statistically analyzed.

STATISTICAL ANALYSIS

The statistical analysis was done using IBM SPSS Statistics for Windows. The statistical significance was set at P ≤ 0.05. Kolmogorov-Smirnov and Shapiro-Wilk test were used to test the normality of the data. The Friedman test and Wilcoxon-signed rank test were carried out for intragroup comparison. Kruskal-Wallis and Mann-Whitney U-test were employed to analyze inter-group comparison.

RESULTS

All the groups showed statistically significant reduction in DI-S, CI-S, OHI-S, PI, and S. mutans count after 15 days.

CONCLUSION

Oil pulling therapy using SO and OSO showed a significant improvement in oral hygiene.

Changes in the gut microbiota during and after commercial helium–oxygen saturation diving in China

Objectives

The influence of commercial helium–oxygen saturation diving on divers’ gut microbiotas was assessed to provide dietary suggestion.

Methods

Faecal samples of 47 divers working offshore were collected before (T1), during (T2) and after (T3) saturation diving. Their living and excursion depths were 55–134 metres underwater with a saturation duration of 12–31 days and PaO2 of 38–65 kPa. The faecal samples were examined through 16S ribosomal DNA amplicon sequencing based on the Illumina sequencing platform to analyse changes in the bacteria composition in the divers’ guts.

Results

Although the α and β diversity of the gut microbiota did not change significantly, we found that living in a hyperbaric environment of helium–oxygen saturation decreased the abundance of the genus Bifidobacterium, an obligate anaerobe, from 2.43%±3.83% at T1 to 0.79%±1.23% at T2 and 0.59%±0.79% at T3. Additionally, the abundance of some short-chain fatty acid (SCFA)-producing bacteria, such as Fusicatenibacter, Faecalibacterium, rectale group and Anaerostipes, showed a decreased trend in the order of before, during and after diving. On the contrary, the abundance of species, such as Lactococcus garvieae, Actinomyces odontolyticus, Peptoclostridium difficile, Butyricimonas virosa, Streptococcus mutans, Porphyromonas asaccharolytica and A. graevenitzii, showed an increasing trend, but most of them were pathogens.

Conclusions

Occupational exposure to high pressure in a helium–oxygen saturation environment decreased the abundance of Bifidobacterium and some SCFA-producing bacteria, and increased the risk of pathogenic bacterial infection. Supplementation of the diver diet with probiotics or prebiotics during saturation diving might prevent these undesirable changes.

Quantitative Proteomics Uncovers the Interaction between a Virulence Factor and Mutanobactin Synthetases in Streptococcus mutans

Streptococcus mutans is the major bacterium associated with dental caries. In order to thrive on the highly populated tooth surface and cause disease, S. mutans must be able to protect itself from hydrogen peroxide-producing commensal bacteria and compete effectively against the neighboring microbes. S. mutans produces mutacins, small antimicrobial peptides which help control the population of competing bacterial species. In addition, S. mutans produces a peptide called mutanobactin, which offers S. mutans protection against oxidative stress. Here, we uncover a new link between the putative glycosyltransferase SMU_833 and the mutanobactin-synthesizing protein complex through quantitative proteomic analysis and a tandem-affinity protein purification scheme. Furthermore, we show that SMU_833 mediates bacterial sensitivity to oxidative stress and bacterial ability to compete with commensal streptococci. This study has revealed a previously unknown association between SMU_833 and mutanobactin and demonstrated the importance of SMU_833 in the fitness of S. mutans.

Streptococcus mutans, the primary etiological agent of tooth decay, has developed multiple adhesion and virulence factors which enable it to colonize and compete with other bacteria. The putative glycosyltransferase SMU_833 is important for the virulence of S. mutans by altering the biofilm matrix composition and cariogenicity. In this study, we further characterized the smu_833 mutant by evaluating its effects on bacterial fitness. Loss of SMU_833 led to extracellular DNA-dependent bacterial aggregation. In addition, the mutant was more susceptible to oxidative stress and less competitive against H₂O₂ producing oral streptococci. Quantitative proteomics analysis revealed that SMU_833 deficiency resulted in the significant downregulation of 10 proteins encoded by a biosynthetic gene cluster responsible for the production of mutanobactin, a compound produced by S. mutans which helps it survive oxidative stress. Tandem affinity purification demonstrated that SMU_833 interacts with the synthetic enzymes responsible for the production of mutanobactin. Similar to the smu_833 mutant, the deletion of the mutanobactin gene cluster rendered the mutant less competitive against H₂O₂-producing streptococci. Our studies revealed a new link between SMU_833 virulence and mutanobactin, suggesting that SMU_833 represents a new virulent target that can be used to develop potential anticaries therapeutics.

IMPORTANCEStreptococcus mutans is the major bacterium associated with dental caries. In order to thrive on the highly populated tooth surface and cause disease, S. mutans must be able to protect itself from hydrogen peroxide-producing commensal bacteria and compete effectively against the neighboring microbes. S. mutans produces mutacins, small antimicrobial peptides which help control the population of competing bacterial species. In addition, S. mutans produces a peptide called mutanobactin, which offers S. mutans protection against oxidative stress. Here, we uncover a new link between the putative glycosyltransferase SMU_833 and the mutanobactin-synthesizing protein complex through quantitative proteomic analysis and a tandem-affinity protein purification scheme. Furthermore, we show that SMU_833 mediates bacterial sensitivity to oxidative stress and bacterial ability to compete with commensal streptococci. This study has revealed a previously unknown association between SMU_833 and mutanobactin and demonstrated the importance of SMU_833 in the fitness of S. mutans.

Potential Novel Strategies for the Treatment of Dental Pulp-Derived Pain: Pharmacological Approaches and Beyond

The diagnosis and management of pain is an everyday occurrence in dentistry, and its effective control is essential to ensure the wellbeing of patients. Most tooth-associated pain originates from the dental pulp, a highly vascularized and innervated tissue, which is encased within mineralized dentin. It plays a crucial role in the sensing of stimuli from the local environment, such as infections (i.e. dental caries) and traumatic injury, leading to a local inflammatory response and subsequently to an increase in intra-pulp pressure, activating nerve endings. However, thermal, chemical, and mechanical stimuli also have the ability to generate dental pulp pain, which presents mechanisms highly specific to this tissue and which have to be considered in pain management. Traditionally, the management of dental pulp pain has mostly been pharmacological, using non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, or restorative (i.e. removal of dental caries), or a combination of both. Both research areas continuously present novel and creative approaches. This includes the modulation of thermo-sensitive transient receptor potential cation channels (TRP) by newly designed drugs in pharmacological research, as well as the use of novel biomaterials, stem cells, exosomes and physical stimulation to obtain pulp regeneration in regenerative medicine. Therefore, the aim of this review is to present an up-to-date account of causes underlying dental pain, novel treatments involving the control of pain and inflammation and the induction of pulp regeneration, as well as insights in pain in dentistry from the physiological, pharmacological, regenerative and clinical perspectives.

Antimicrobial and antibiofilm effects of abietic acid on cariogenic Streptococcus mutans

Dental caries is a type of oral microbiome dysbiosis and biofilm infection that affects oral and systemic conditions. For healthy life expectancy, natural bacteriostatic products are ideal for daily and lifetime use as anti-oral infection agents. This study aimed to evaluate the inhibitory effects of abietic acid, a diterpene derived from pine rosin, on the in vitro growth of cariogenic bacterial species, Streptococcus mutans. The effective minimum inhibitory concentration of abietic acid was determined through observation of S. mutans growth, acidification, and biofilm formation. The inhibitory effects of abietic acid on the bacterial membrane were investigated through the use of in situ viability analysis and scanning electron microscopic analysis. Cytotoxicity of abietic acid was also examined in the context of several human cell lines using tetrazolium reduction assay. Abietic acid was found to inhibit key bacterial growth hallmarks such as colony forming ability, adenosine triphosphate activity (both planktonic and biofilm), acid production, and biofilm formation. Abietic acid was identified as bacteriostatic, and this compound caused minimal damage to the bacterial membrane. This action was different from that of povidone-iodine or cetylpyridinium chloride. Additionally, abietic acid was significantly less cytotoxic compared to povidone-iodine, and it exerted lower toxicity towards epithelial cells and fibroblasts compared to that against monocytic cells. These data suggest that abietic acid may prove useful as an antibacterial and antibiofilm agent for controlling S. mutans infection.

Inactivation of the pgmA Gene in Streptococcus mutans Significantly Decreases Biofilm-Associated Antimicrobial Tolerance

Screening of a Streptococcus mutans mutant library indicated that pgmA mutants displayed a reduced biofilm-associated tolerance toward gentamicin. The biofilms formed by the S. mutanspgmA mutant also displayed decreased tolerance towards linezolid and vancomycin compared to wild-type biofilms. On the contrary, the resistance of planktonic S. mutanspgmA cells to gentamycin, linezolid, and vancomycin was more similar to wild-type levels. Investigations of biofilms grown in microtiter trays and on submerged glass slides showed that pgmA mutants formed roughly the same amount of biofilm as the wild type, indicating that the reduced antimicrobial tolerance of these mutants is not due to diminished biofilm formation. The pgmA gene product is known to be involved in the synthesis of precursors for cell wall components such as teichoic acids and membrane glycolipids. Accordingly, the S. mutanspgmA mutant showed increased sensitivity to Congo Red, indicating that it has impaired cell wall integrity. A changed cell wall composition of the S. mutanspgmA mutant may play a role in the increased sensitivity of S. mutanspgmA biofilms toward antibiotics.

Trans,trans-farnesol, an antimicrobial natural compound, improves glass ionomer cement properties

A series of experiments were conducted to characterize a novel restorative material. We explored the effect on biological, physical and chemical properties of glass ionomer cement (GIC) adding-the naturally occurring tt-farnesol (900 mM). Two groups were accomplished for all assays: GIC+tt-farnesol and GIC (control). Biological assays: 1) agar diffusion against some cariogenic bacteria; 2) S. mutans biofilm formation and confocal laser scanning microscopy-CLSM. 3) gtfB, gtfC, gtfD, gbpB, vicR, and covR expression; 4) MTT and microscopic morphology. Physical properties assays: 1) roughness; 2) hardness; 3) compressive strength and 4) diametral tensile strength. Chemical assay: Raman spectroscopy. The adding of tt-farnesol to GIC led to larger zones of inhibition (p<0.05), biofilms with a short-term reduction in bacterial viability but similar biomass (p>0.05). Polysaccharides levels increased over time, similarly over groups (p>0.05). Viable and non-viable S. mutans were seen on the specimens’ surface by CLSM but their virulence was not modulated by tt-farnesol. The tt-farnesol increased the HaCaT cell viability without impact on compressive and diametral tensile strength and roughness although the hardness was positively affected (p<0.05). Raman confirmed the presence of tt-farnesol. The incorporation of tt-farnesol into GIC inhibited the growth of cariogenic bacteria but had a little effect on the composition, structure and physiology of the biofilm matrices. Also, the tt-farnesol increased the hardness and the biocompatibility of the GIC, not influencing negatively other physical properties of the restorative material.

Effects of nano-hydroxyapatite on the formation of biofilms by Streptococcus mutans in two different media

OBJECTIVES

The aim of this study was to examine the effect of nano-hydroxyapatite (nHA) on biofilm formation by Streptococcus mutans, which is actively involved in the initiation of dental caries.

DESIGN

The effects of nHA on growth and biofilm formation by S. mutans were investigated in two media: a saliva analog medium, basal medium mucin (BMM); and a nutrient-rich medium, brain heart infusion (BHI); in the presence and absence of sucrose.

RESULTS

Sucrose enhanced the growth of S. mutans in both media. In the presence of sucrose, nHA enhanced bacterial growth and biofilm formation more in BMM medium than in BHI. nHA also affected the transcription of glucosyltransferase (gtf) genes and production of polysaccharide differently in the two media. In BHI medium, the transcription of all three gtf genes, coding for enzymes that synthesize soluble and insoluble glucans from sucrose, was increased more than 3-fold by nHA. However, in BMM medium, only the transcription of gtfB and gtfC, coding for insoluble glucans, was substantially enhanced by nHA.

CONCLUSIONS

nHA appeared to enhance biofilm formation by increasing glucosyltransferase transcription, which resulted in an increase in production of insoluble glucans. This effect was influenced by the growth conditions.

Relationship of Streptococcus mutans with valvar cardiac tissue: A molecular and immunohistochemical study

BACKGROUND

The present study aimed to investigate the presence or absence of Streptococcus mutans in oral cavity and valvular samples associating with the histomorphologic alterations of calcified aortic stenosis.

METHODOLOGY

Dental plaque and cardiac valve samples were collected from 10 patients with calcified aortic stenosis for molecular analysis of S mutans by real-time polymerase chain reaction (PCR). Healthy valve tissue was also collected from five young cadavers and analyzed for S mutans. Moreover, fragments of all valvar specimens were submitted for histomorphological analysis and immunohistochemistry (anti-S mutans and anti-CD61).

RESULTS

Streptococcus mutans was present in 100% of the oral cavity samples from the patients with calcified aortic stenosis in the molecular analysis. The analysis by real-time PCR showed that S mutans presented the same proportion in healthy valves and those with calcified aortic stenosis (80%; P = 1.000). Conversely, the immunoexpression of S mutans was 37.40 (IC95% = 1.49-937.00) times superior in samples of patients with cardiac disease (P = .007). The immunoexpression analysis showed that CD61 was present in seven (70%) calcified aortic stenosis samples, all of which were also immunopositive for S mutans.

CONCLUSIONS

Streptococcus mutans was found in the oral cavity, healthy valve tissue, and calcified aortic stenosis samples. However, the microorganism was visualized by immunohistochemistry only in the calcified aortic stenosis samples, which may suggest viability and an increased bacterial density in this condition. The association of the presence of S mutans and positive CD61 immunoexpression suggests a probable relationship with calcified aortic stenosis.

A Novel Dental Sealant Containing Dimethylaminohexadecyl Methacrylate Suppresses the Cariogenic Pathogenicity of Streptococcus mutans Biofilms

Cariogenic oral biofilms are strongly linked to dental caries around dental sealants. Quaternary ammonium monomers copolymerized with dental resin systems have been increasingly explored for modulation of biofilm growth. Here, we investigated the effect of dimethylaminohexadecyl methacrylate (DMAHDM) on the cariogenic pathogenicity of Streptococcus mutans (S. mutans) biofilms. DMAHDM at 5 mass% was incorporated into a parental formulation containing 20 mass% nanoparticles of amorphous calcium phosphate (NACP). S. mutans biofilms were grown on the formulations, and biofilm inhibition and virulence properties were assessed. The tolerances to acid stress and hydrogen peroxide stress were also evaluated. Our findings suggest that incorporating 5% DMAHDM into 20% NACP-containing sealants (1) imparts a detrimental biological effect on S. mutans by reducing colony-forming unit counts, metabolic activity and exopolysaccharide synthesis; and (2) reduces overall acid production and tolerance to oxygen stress, two major virulence factors of this microorganism. These results provide a perspective on the value of integrating bioactive restorative materials with traditional caries management approaches in clinical practice. Contact-killing strategies via dental materials aiming to prevent or at least reduce high numbers of cariogenic bacteria may be a promising approach to decrease caries in patients at high risk.

Targeting S. mutans biofilms: a perspective on preventing dental caries

The prevalence of biofilm diseases, and dental caries in particular, have encouraged extensive research on S. mutans biofilms, including methods of preventing its formation. Numerous small molecules with specific anti-biofilm activity against this pathogen have been isolated and synthesized. Generally, these molecules can be characterized into three categories: sucrose-dependent anti-adhesion, sucrose-independent anti-adhesion and cellular signaling interference. This review aims to provide an overview of the current small molecule strategies used for targeting S. mutans biofilms, and a perspective of the future for the field.

Graphene-based nanomaterials: the promising active agents for antibiotics-independent antibacterial applications

Graphene-based nanomaterials, such as graphene oxide (GO) and reduced graphene oxide (rGO), have shown great potentials in drug delivery and photodynamic/photothermal therapy due to their featured structure and physicochemical properties. In recent years, their antibacterial potentials have also been exploited. The commonly recognized antibacterial mechanisms include sharp edge-mediated cutting effect, oxidative stress and cell entrapment. This antibacterial activity is very important for human health. As we know, infection with the pathogenic bacteria, especially the drug-resistant ones, is a great threat to human lives. Thus, the development of the antibiotics-independent and drug-free antibacterial agents is of great importance and significance. Graphene-based nanomaterials are a kind of such antibacterial agents. An insight into their properties and antibacterial mechanisms is necessary before they are developed into real products. Herein, we provide a comprehensive understanding of the antibacterial application of graphene-based nanomaterials via summarizing their antibacterial activities against some typical microbial species and discussing their unique mechanisms. In addition, the side-effects and problems in using these nanomaterials are also discussed.