Anti-carious Effects ofGalla chinensis: A Systematic Review

Plant-Derived Compounds: A Promising Tool for Dental Caries Prevention

There is a growing shift from the use of conventional pharmaceutical oral care products to the use of herbal extracts and traditional remedies in dental caries prevention. This is attributed to the potential environmental and health implications of contemporary oral products. This comprehensive review aims at the analysis of plant-derived compounds as preventive modalities in dental caries research. It focuses on data collected from 2019 until recently, trying to emphasize current trends in this topic. The research findings suggest that several plant-derived compounds, either aqueous or ethanolic, exhibit notable antibacterial effects against Streptococcus mutans and other bacteria related to dental caries, with some extracts demonstrating an efficacy comparable to that of chlorhexidine. Furthermore, in vivo studies using plant-derived compounds incorporated in food derivatives, such as lollipops, have shown promising results by significantly reducing Streptococcus mutans in high-risk caries children. In vitro studies on plant-derived compounds have revealed bactericidal and bacteriostatic activity against S. mutans, suggesting their potential use as dental caries preventive agents. Medicinal plants, plant-derived phytochemicals, essential oils, and other food compounds have exhibited promising antimicrobial activity against oral pathogens, either by their anti-adhesion activity, the inhibition of extracellular microbial enzymes, or their direct action on microbial species and acid production. However, further research is needed to assess their antimicrobial activity and to evaluate the cytotoxicity and safety profiles of these plant-derived compounds before their widespread clinical use can be recommended.

Herbal Mouthrinses for Prevention of Dental Caries in Children and Adolescents: A Systematic Review

The primary aim of this study was to evaluate the effectiveness of herbal mouthrinses (HMR) on caries prevention in children and adolescents. In addition, this systematic review assessed its effectiveness in remineralization of white spot lesions, reduction of halitosis, and improving gingival and periodontal health in orthodontic patients and patients with special healthcare needs (SHCN). A comprehensive bibliographic search was conducted in PubMed, Cochrane Central, EMBASE, AMED, ProQuest, CINAHL, AYUSH, Digital Helpline for Ayurveda Research Articles (DHARA), and Clinical Trial Gov databases. A total of 3,918 titles were identified during the initial search. Of these, 32 studies were selected for quality assessment. A total of 5,038 participants from 10 countries were thus included in this review, with 22 (66.7%) studies conducted in India. All included studies were published between 2004 and 2021. Included studies investigated the effect of HMR on caries increments, which record decayed, missing, filled (DMF) [International Caries Detection and Assessment System (ICDAS)], decayed, missing, filled teeth/surfaces (DMFT/S), and incipient caries. Changes in bacterial count (Streptococcus mutans and Lactobacillus) and alterations in levels of Candida albicans from saliva or plaque samples were also reported. The effect of HMR on gingival and plaque indices among adolescents undergoing orthodontic treatment and children with SHCN was reported in two studies. The variance in the HMR formula across studies, short follow-up period, and limiting grade of evidence do not allow for conclusive evidence of the efficacy of HMR. This warrants high-quality randomized controlled trials (RCTs) with longer intervention periods involving children under 6 years to yield more conclusive results.

How to cite this article

Saikia AM, Sivasubramanian A, MS M, et al. Herbal Mouthrinses for Prevention of Dental Caries in Children and Adolescents: A Systematic Review. Int J Clin Pediatr Dent 2024;17(S-1):S100-S111.

Combined proteomic and transcriptomic analysis of the antimicrobial mechanism of tannic acid against Staphylococcus aureus

Staphylococcus aureus is a zoonotic opportunistic pathogen that represents a significant threat to public health. Previous studies have shown that tannic acid (TA) has an inhibitory effect on a variety of bacteria. In this study, the proteome and transcriptome of S. aureus were analyzed to comprehensively assess changes in genes and proteins induced by TA. Initial observations of morphological changes revealed that TA damaged the integrity of the cell membrane. Next, proteomic and genetic analyses showed that exposure to TA altered the expression levels of 651 differentially expressed proteins (DEPs, 283 upregulated and 368 downregulated) and 503 differentially expressed genes (DEGs, 191 upregulated and 312 downregulated). Analysis of the identified DEPs and DEGs suggested that TA damages the integrity of the cell envelope by decreasing the expression and protein abundance of enzymes involved in the synthesis of peptidoglycans, teichoic acids and fatty acids, such as murB, murQ, murG, fmhX and tagA. After treatment with TA, the assembly of ribosomes in S. aureus was severely impaired by significant reductions in available ribosome components, and thus protein synthesis was hindered. The levels of genes and proteins associated with amino acids and purine synthesis were remarkably decreased, which further reduced bacterial viability. In addition, ABC transporters, which are involved in amino acid and ion transport, were also badly affected. Our results reveal the molecular mechanisms underlying the effects of TA on S. aureus and provide a theoretical basis for the application of TA as an antibacterial chemotherapeutic agent.

A Chinese herb preparation, honokiol, inhibits Streptococcus mutans biofilm formation

OBJECTIVE

This study aimed to investigate the antibiofilm and anticariogenic effects of honokiol, a traditional Chinese medicine, on the cariogenic bacterium Streptococcus mutans (S. mutans).

DESIGN

The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of honokiol on S. mutans UA159 were measured. Then, S. mutans were treated with honokiol at concentrations of 1/2 MIC and 1/4 MIC. Extracellular polysaccharide (EPS) synthesis was assessed with confocal laser scanning microscopy (CLSM) and the anthrone-sulfuric method. Crystal violet staining and scanning electron microscopy (SEM) were used to demonstrate the characteristics and morphology of S. mutans biofilms. Colony-forming unit (CFU) assay was performed to observe the antibacterial effect of honokiol. Lactic acid production of 24-h biofilms was measured by the lactic acid assay. The expression level of caries-related genes (gtfB/C/D, comD/E and ldh) was identified by quantitative real-time PCR (qRTPCR) to explore the relevant mechanism. And the cytotoxic effect on human gingival fibroblasts (HGFs) was evaluated by the Cell Counting Kit-8 (CCK-8) assay.

RESULTS

The MIC and MBC of honokiol on S. mutans were 30 μg/mL and 60 μg/mL, respectively. Honokiol inhibited biofilm formation, EPS synthesis and lactic acid production. It also decreased the expression of glucosyltransferases (Gtfs) and quorum sensing (QS) system encoding genes. Moreover, honokiol showed favorable biocompatibility with HGFs.

CONCLUSIONS

Honokiol has an inhibitory effect on S. mutans and favorable biocompatibility, with application potential as a novel anticaries agent.

Antimicrobial Activity of Tannic Acid In Vitro and Its Protective Effect on Mice against Clostridioides difficile

Clostridioides difficile infection (CDI), recurrently reported as an urgent threat owing to its increased prevalence and mortality, has attracted significant attention. As the use of antibiotics to treat CDI has many limitations, such as high recurrence rate, the need to actively seek and develop other drugs that can effectively treat CDI with fewer side effects has become a key issue in CDI prevention and treatment. This study aimed to evaluate the inhibitory effect of Galla chinensis (GC) and its main component, tannic acid (TA), against C. difficile in vitro and its therapeutic effect on CDI in vivo. When GC and TA concentrations were 250 and 64 mg/L, respectively, the cumulative antibacterial rate against C. difficile reached 100%. The sub-MIC of TA significantly inhibited C. difficile sporulation, toxin production, and biofilm formation in vitro. Compared with the CDI control group, TA-treated mice lost less weight and presented a significantly improved survival rate. TA significantly reduced the number of spores in feces, decreased serum TcdA level, and increased serum interleukin 10 (IL-10). Based on the inhibitory effect of TA on C. difficile in vitro and its therapeutic effect on the CDI mouse model, we consider TA as a potentially effective drug for treating CDI. IMPORTANCE Clostridioides difficile is one of the major pathogens to cause antibiotic-associated diarrhea. Although antibiotic treatment is still the most commonly used and effective treatment for CDI, the destruction of indigenous intestinal microbiota by antibiotics is the main reason for the high CDI recurrence rate of about 20%, which is increasing every year. Moreover, the growing problem of drug resistance has also become a major hidden danger in antibiotic treatment. GC has been used to treat diarrhea in traditional Chinese medicine. In the present study, we evaluated the inhibitory effect of TA, the main component of GC, on dissemination and pathogenic physiological functions of C. difficile in vitro, as well as its therapeutic efficacy in a CDI model. Overall, TA is considered to be a potentially effective drug for CDI treatment.

Identification of Medicinal Compounds of Fagopyri Dibotryis Rhizome from Different Origins and Its Varieties Using UPLC-MS/MS-Based Metabolomics

Fagopyrum dibotrys, being native to southwest China, is widely distributed in Yunnan, Guizhou Provinces and Chongqing City. However, the quality of medicinal materials growing in different origins varies greatly, and cannot meet the market demand for high-quality F. dibotrys. In this study, 648 metabolites were identified, and phenolic compounds of F. dibotrys from different origins were clearly separated by principal component analysis (PCA). Our results suggested that the medicinal differences of F. dibotrys from different origins can be elucidated via the variations in the abundance of the phenolic and flavonoid compounds. We found that the epicatechin, total flavonoids and total tannin content in Yunnan Qujing (YQ) and Yunnan Kunming (YK) were higher than those in Chongqing Shizhu (CS), Chongqing Fuling (CF) and Guizhou Bijie (GB), suggesting that Yunnan Province can be considered as one of the areas that produce high-quality medicinal materials. Additionally, 1,6-di-O-galloyl-β-D-glucose, 2,3-di-O-galloyl-D-glucose and gallic acid could be used as ideal marker compounds for the quality control of F. dibotrys from different origins caused by metabolites, and the F. dibotrys planted in Yunnan Province is well worth exploiting.

Pharmacological effects and mechanisms of tannic acid

In recent years, increasing attention has been paid to the pharmacological efficacy of tannins. Tannic acid (TA), the simplest hydrolysable tannin that has been approved by the FDA as a safe food additive, is one of the most important components of these traditional medicines. Studies have shown that TA displays a wide range of pharmacological activities, such as anti-inflammatory, neuroprotective, antitumor, cardioprotective, and anti-pathogenic effects. Here, we summarize the known pharmacological effects and associated mechanisms of TA. We focus on the effect and mechanism of TA in various animal models of inflammatory disease and organ, brain, and cardiovascular injury. Moreover, we discuss the possible molecular targets and signaling pathways of TA, in addition to the pharmacological effects of TA-based nanoparticles and TA in combination with chemotherapeutic drugs.

The Current Antimicrobial and Antibiofilm Activities of Synthetic/Herbal/Biomaterials in Dental Application

Herbal and chemical products are used for oral care and biofilm treatment and also have been reported to be controversial in the massive trials conducted in this regard. The present review is aimed at evaluating the potential of relevant herbal and chemical products and comparing their outcomes to conventional oral care products and summarizing the current state of evidence of the antibiofilm properties of different products by evaluating studies from the past eleven years. Chlorhexidine gluconate (CHX), essential oils (EOs), and acetylpyridinium chloride were, respectively, the most commonly studied agents in the included studies. As confirmed by all systematic reviews, CHX and EO significantly control the plaque formation and gingival indices. Fluoride is another interesting reagent in oral care products that has shown promising results of oral health improvement, but the evidence quality needs to be refined. The synergy between natural plants and chemical products should be targeted in the future to accede to the formation of new, efficient, and healthy anticaries strategies. Moreover, to discover their biofilm-interfering or biofilm-inhibiting activities, effective clinical trials are needed. In this review article, therapeutic applications of herbal/chemical materials in oral biofilm infections are discussed in recent years (2010-2022).

The complete chloroplast genome of Rhus punjabensis var. sinica

Rhus punjabensis var. sinica belongs to the family Anacardiaceae in the order Sapindales. In this study, we first reported the complete chloroplast genome sequence of R. punjabensis var. sinica. The cp genome was sequenced on Illumina Hiseq 2000 platform. The sequence was found to be 159,617 bp in length with 37.9% GC contents, including a large single-copy region of 87,694 bp, a small single-copy region of 18,971 bp, and a pair of inverted repeats of 26,476 bp. The chloroplast genome of R. punjabensis var. sinica contains 133 genes, including 86 protein-coding genes, 8 rRNA genes, and 2 pseudogenes identified by CPGAVAS2 and BLAST search, and 37 tRNA genes annotated by tRNAscan-SE. Maximum-likelihood (ML) phylogenetic analysis showed that R. punjabensis var. sinica was sister to Rhus potaninii.

Galla Chinensis, a Traditional Chinese Medicine: Comprehensive review of botany, traditional uses, chemical composition, pharmacology and toxicology

ETHNOPHARMACOLOGICAL RELEVANCE

Galla chinensis (GC), a traditional Chinese medicine (TCM), has a wide range of pharmacological properties which have been widely used for more than 1400 years. Based on shape, GC is divided into two groups: jiaobei and dubei. It is a bitter, sour, cold and astringent substance which is usually used for treating diarrhea, constipation, bleeding, cough, vomiting, sweating, hemorrhoids, and anal and uterine prolapse. It is distributed in Japan, North Korea, and all parts of China.

AIM OF STUDY

This study was aimed at carrying out a comprehensive overview of the current status of research on Galla chinensis (GC) for better understanding of it characteristics, while providing a clear direction for future studies. It has aroused the interest of researchers, leading to development of medicinal value, expansion of its application, and provision of wider and more effective drug choices. This study was focused on the traditional uses, botany, chemical composition, pharmacology and toxicology of GC. Finally, the study focused on possible future research directions for GC.

MATERIALS AND METHODS

A comprehensive analysis was done based on academic papers, pharmaceutical monographs, ancient medicinal works, and drug standards of China. This review used Galla and Galla chinensis as keywords for retrieval of information on GC from online databases such as PubMed, Elsevier, CNKI, Web of Science, Google Scholar, SCI hub, and Baidu academic.

RESULTS

It was found that the chemical constituents of GC included tannins, phenolic acid, amino acids and fatty acid, with polyphenol compounds (especially tannins and gallic acid) as the distinct components. In vitro and in vivo studies revealed that GC exerted numerous biological effects such as anti-caries, antibacterial, antiviral, anticancer, and antioxidant effects. The therapeutic effect of GC was attributed mainly to the biological properties of its bioactive components.

CONCLUSIONS

GC is an important TCM which has potential benefit in the treatment of a variety of diseases. However, the relationship amongst the structure and biological activity of GC and its components, mechanism of action, toxicity, pharmacokinetics and target organs need to be further studied. Quality control and quality assurance programs for GC need to be further developed. There is need to study the dynamics associated with the accumulation of chemical compounds in GC as well as the original plants and aphid that form GC.

Enamel remineralization and surface roughness after treatment with herbal-containing toothpastes

Background

Oral care products containing bioactive agents obtained from extracts of plant drugs were launched. This in vitro study investigated the effects of herbal-containing toothpastes associated or not with fluoride to remineralize the enamel after cariogenic challenge with pH cycling. The chemical and physical factors of toothpastes and the enamel surface roughness after brushing were also analyzed.

Material and Methods

Sixty bovine enamel blocks were obtained and divided into 3 thirds: intact (untreated), demineralized (artificial caries lesion), and treated (caries lesion, pH cycling, and brushing with toothpastes). Toothpastes containing herbal compounds contained no fluoride [Galla chinensis (GCH)], low-F concentration [D’Or (DOR); Herbal Bliss (HBL)], or a different fluoride type [Elmex Anticaries (EAC)]. The results were compared to NaF-containing toothpastes: 1450 and 5000 ppm. Enamel blocks were brushed with the toothpastes using a pH-cycling model (7 days). The Knoop hardness (25g/10s) of the surface and the longitudinal sections were then evaluated. The percentage of surface hardness recovery (%SHR) was calculated. The enamel surface roughness, pH, particle size, zeta potential, and polydispersity index of toothpaste slurries were also evaluated. Data were statistically analyzed (α=5%).

Results

No significance was observed when %SHR was compared (p>0.05). DOR, GCH, and HBL were more effective in remineralizing the enamel subsurface. Significantly higher surface roughness was observed when treated with EAC and GCH (p<0.05).

Conclusions

All toothpastes were able to remineralize the enamel, especially the subsurface, with results equal or better than that of standard toothpastes.

Key words:Enamel, hardness, roughness, toothpaste, tooth remineralization.

Water Extract of Gallnut Reduces the Injury of Alveolar Epithelial Cells Induced by Streptococcus pneumoniae by Up-Regulating miRNA-338-3p

Streptococcus pneumoniae (S. pneumoniae) is the primary pathogen causing pneumonia, in addition to lobar pneumonia, meningitis, bronchitis, and other diseases. Inhibiting the apoptosis and inflammation of alveolar epithelial cells is essential for the treatment of pneumonia caused by S. pneumoniae. Traditional Chinese medicine has the characteristics of multiple components, multiple targets, and few adverse reactions. It is recognized by doctors and patients in the treatment of pneumonia and other diseases. We conducted this study to explore the effect of the water extract of gallnut on alveolar epithelial cells affected by S. pneumoniae. Studies have found that the water extract of gallnut can increase the optical density value, Bcl-2 protein expression, IL-10 content, and miRNA-338-3p levels of alveolar epithelial cells affected by S. pneumoniae. Additionally, it can reduce the rate of cell apoptosis, Bax protein expression, and IL-6 content. Further, its effect is dose-dependent: the higher the concentration of gallnut water extract, the more evident its effect on alveolar epithelial cells. Through nano PCR detection, it was found that overexpression of miRNA-338-3p can increase the activity of alveolar epithelial cells affected by S. pneumoniae and promote cell growth. Knockdown of miRNA-338-3p reduced the impact of the water extract of gallnut on the growth of alveolar epithelial cells and the expression of inflammatory factors affected by S. pneumoniae. Therefore, our findings suggest that the water extract of gallnut could inhibit the apoptosis of alveolar epithelial cells affected by S. pneumoniae by up-regulating the expression of miRNA-338-3p.

Ecological determinants of effect of a free pit and fissure sealant program in Shanxi, China, 2017-2018

BACKGROUND

The aim of this study is to explore the spatial heterogeneity of the retention of PFS in children aged 7-9 years in Shanxi Province, North China and investigate the risk factors associated with PFS retention.

METHODS

In this study, 937 children aged 7-9 years from Shanxi Province, China were randomly selected, all of whom had at least one first permanent tooth sealed with PFS in 2016. The children were surveyed after 12 months (in 2017) and 24 months (in 2018). The Geo-detector model was used to explore the spatial heterogeneity of the retention rate of PFS and analyze the influence and interactions of the ecological factors on PFS.

RESULTS

3299 teeth from 937 children were analyzed. The PFS full retention rates after 12 months (in 2017) and 24 months (in 2018) were 81.6% and 75.1%, respectively. The incidence of caries of the first molar was 2.1% after 12 months and 5.4% after 24 months. The spatial heterogeneity of the PFS retention rate after 24 months was significant, which was shown as the retention rate of PFS increased from north to south after 24 months. Remarkably, the natural environmental factors exerted greater influence than the socioeconomic and medical resources factors after 12 months, where the interaction of fluorine in water (FW) had the strongest explanatory power of 52% (P < 0.05). The medical resources were important ecological factors after 24 months, and the percentage of medical technicians (PMT) had the strongest explanatory power of 70% (P < 0.05).

CONCLUSION

The natural environmental factors and medical resources factors are important ecological factors determining the spatial pattern. The government should strengthen medical and technician construction in North China, comprehensively control fluoride in water, optimize the allocation of medical resources, and promote the balanced development of regional medicine.

In vitro mineral apposition analysis of two Colombian plant extracts on Amelogenesis imperfecta teeth

OBJECTIVE

To determine if native Colombian Piper marginatum Jacq. and Ilex guayusa Loes plant extracts have a remineralizing effect on teeth with Amelogenesis imperfecta in comparison with the commercial products Clinpro-3M and Recaldent™.

MATERIAL AND METHODS

An in vitro study was carried out with 128 human teeth slices (64 healthy and 64 with Amelogenesis imperfecta) on which an initial Raman spectroscopy was performed followed by Raman spectroscopies at 0, 24, 48, and 72 h to determine possible remineralization by observing mineral increase or decrease as a result of P. marginatum Jacq. and I. guayusa Loes extract application in comparison to control substance (Clinpro and Recaldent™) application. Obtained data were analyzed using a bivariate method with a t unidirectional test. Significant differences among groups were determined by an ANOVA with Dunnett post hoc tests.

RESULTS

Native I. guayusa Loes and P. marginatum Jacq. Colombian plants extracts exhibited phosphate and orthophosphate mineral apposition, where P. marginatum Jacq. presented better results.

CONCLUSIONS

Native Colombian I. guayusa Loes and P. marginatum Jacq plant extract might in the future be useful for dental tissue remineralization, as they induced phosphate and orthophosphate mineral apposition, main components of tooth enamel. These types of natural compounds can become an alternative to fluorine, whose ingestion is harmful to the human body.

Inhibition of Streptococcus mutans biofilm formation by strategies targeting the metabolism of exopolysaccharides

Dental caries is one of the most prevalent and costly biofilm-associated infectious diseases affecting most of the world's population. In particular, dental caries is driven by dysbiosis of the dental biofilm adherent to the enamel surface. Specific types of acid-producing bacteria, especially Streptococcus mutans, colonize the dental surface and cause damage to the hard tooth structure in the presence of fermentable carbohydrates. Streptococcus mutans has been established as the major cariogenic pathogen responsible for human dental caries, with a high ability to form biofilms. The exopolysaccharide (EPS) matrix, mainly contributed by S. mutans, has been considered as a virulence determinant of cariogenic biofilm. As EPS is an important virulence factor, targeting EPS metabolism could be useful in preventing cariogenic biofilm formation. This review summarizes plausible strategies targeting S. mutans biofilms by degrading EPS structure, inhibiting EPS production, and disturbing the EPS metabolism-related gene expression and regulatory systems.

Current herbal medicine as an alternative treatment in dentistry: In vitro, in vivo and clinical studies

Since the time that human population comprehended the importance of general health maintenance and the burden of disease, there has been a search for healing properties in the natural environment. Herbal medicine is the use of plants with medical properties for prevention and treatment of conditions that can affect general health. Recently, a growing interest has been observed toward the use of traditional herbal medicine alongside synthetic modern drugs. Around 80% of the population, especially in developing countries relies on it for healthcare. Oral healthcare is considered a major part of general health. According to the world health organization (WHO), oral health is considered an important part of general health and quality of life. The utilization of natural medications for the management of pathologic oro-dental conditions can be a logical alternative to pharmaceutical methods due to their availability, low costs, and lower side effects. The current literature review aimed at exploration of the variety and extent of herbal products application in oral health maintenance including different fields of oral healthcare such as dental caries, periodontal maintenance, microbial infections, oral cancers, and inflammatory conditions.

The effect of polyphenol-containing solutions on in situ biofilm formation on enamel and dentin

OBJECTIVES

To investigate the effects of Chinese gallnut extracts and pure tannic acid on in situ biofilm formation on enamel and dentin samples over 24 h.

METHODS

Bovine enamel and dentin samples were buccally fixed on maxillary splints. Six volunteers wore the splints for 24 h, and rinsed their mouths with tap water (control), 1% tannic acid- and 1% Chinese gallnut extracts-containing solution twice a day, 3 min after the splints were placed in the mouth and before night sleep. Live/dead staining was used for fluorescence microscopic (FM) visualization and quantification of bacteria viability of biofilms formed on enamel and dentin samples. Biofilm coverage was evaluated and recorded by FM and scanning electron microscopy (SEM). In addition, biofilms were analyzed by transmission electron microscopy (TEM). The Kruskal-Wallis test was used to analyze biofilm data.

RESULTS

Rinsing with tannic acid- and Chinese gallnut extracts-containing solutions significantly reduced in situ biofilm coverage on enamel and dentin samples (P < 0.05). The bacterial viability of biofilms formed on enamel samples was significantly reduced compared to the control (P < 0.05). TEM analysis revealed an increase in pellicle's electron density and thickness and only few or no bacteria adherent to the pellicle in the experimental samples.

CONCLUSIONS

Rinsing with tannic acid- and Chinese gallnut extracts-containing solutions can effectively inhibit in situ biofilm formation, modify the ultrastructure of biofilms on enamel and dentin surfaces and significantly reduce the bacterial viability of biofilm on enamel surfaces.

CLINICAL SIGNIFICANCE

Tannic acid- and Chinese gallnut extracts-containing solutions might be used for dental biofilm management.

The Effects of a Toothpaste Containing the Active Ingredients of Galla chinensis and Sodium Fluoride on Dentin Hypersensitivity and Sealing of Dentinal Tubules: An In Vitro Study and an Eight-Week Clinical Study in 98 Patients

BACKGROUND This study aimed to evaluate the desensitizing effect of toothpaste containing the active ingredients of an extract of Galla chinensis, both in vitro and in patients with dentin hypersensitivity. MATERIAL AND METHODS Ninety-eight patients with dentin hypersensitivity were divided into two study groups and given toothpaste containing either the active ingredients of Galla chinensis extract and sodium fluoride, or a control toothpaste containing only sodium fluoride. Assessments included the tactile stimulation test and the Schiff cold air sensitivity scale, which were conducted at the baseline examination and after 4 and 8 weeks of dental brushing. Twenty-five intact human premolars from 24 patients with dentin hypersensitivity were prepared and randomly divided into four groups, the untreated baseline group, the study group, the positive control group, and the control group. After brushing with different toothpaste for 7 days, the effects on dentinal tubule sealing in each group was determined by scanning electron microscopy (SEM), and the degree of dentinal tubule plugging and diameter of the open dentinal tubules were calculated. RESULTS Toothpaste containing the active ingredients of Galla chinensis and sodium fluoride significantly reduced the degree of dentin hypersensitivity when compared with toothpaste containing sodium fluoride alone after 4 weeks and 8 weeks of use. Toothpaste containing the active ingredients of Galla chinensis significantly reduced the number and diameter of the open dentinal tubules. CONCLUSIONS Toothpaste that contained the active ingredients of Galla chinensis and sodium fluoride reduced the symptoms of dentin hypersensitivity by sealing the dentinal tubules.

Preparation and Characterization of UV-Curable Acrylic Membranes Embedding Natural Antioxidants

We examine the behaviour of acrylic resin-based membranes containing natural anti-oxidants, such as Galla chinensis tea powder extract (TP) and Taiwanese green propolis (TGP), in different concentrations ranging between 5 and 20 wt %. Membrane morphology was investigated by means of Environmental Scanning Electron Microscopy (ESEM), while the UV-curing reaction was monitored by Fourier-Transform Infra-red (FTIR) spectroscopy. In most cases Thermogravimetric (TG), Differential Scanning Calorimetric (DSC) and Dynamo-mechanical Thermal (DMT) analyses showed that the desirable characteristics of the UV-cured acrylic resin are not substantially altered by the presence of the organic fillers. The release kinetics of polyphenols and flavonoids, determined in water for TP-containing membranes (ETx) and in ethanol/water mixture (7:3 v/v) for TGP-containing ones (EPx), was satisfactory, reaching a plateau after 24 h. Finally, preliminary antibacterial tests against S. epidermidis were performed on the membranes with higher additive amount and gave positive results for ET-type; on the contrary, no inhibitory effect was observed for the tested EP-type membranes.

State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management

The principles of minimally invasive dentistry clearly dictate the need for clinically effective measures to remineralize early enamel caries lesions. While fluoride-mediated remineralization is the cornerstone of current caries management philosophies, a number of new remineralization strategies have been commercialized or are under development that claim to promote deeper remineralization of lesions, reduce the potential risks associated with high-fluoride oral care products, and facilitate caries control over a lifetime. These non-fluoride remineralizing systems can be broadly categorized into biomimetic enamel regenerative technologies and the approaches that repair caries lesions by enhancing fluoride efficacy. This paper discusses the rationale for non-fluoride remineralization and the mechanism of action, challenges, and evidence behind some of the most promising advances in enamel remineralization therapies.

Remineralization Efficacy of an Amelogenin-Based Synthetic Peptide on Carious Lesions

Objective: The aim of this study was to evaluate the remineralization efficacy of an amelogenin-based peptide on initial enamel carious lesions in vitro. Furthermore, we attempted to provide insights into the possible mechanism of the remineralization, including determining the calcium-binding properties of the peptide and its effects on calcium phosphate mineralization.

Methods: The peptide comprising the N-terminus and the C-terminus of porcine amelogenin was synthesized by Synpeptide Co., Ltd. Fifty specimens were randomly assigned to five immersing treatment groups for 12 days: remineralizing medium only; 12.5 μg/mL peptide + remineralizing medium; 25 μg/mL peptide + remineralizing medium; 50 μg/mL peptide + remineralizing medium; fluoride + remineralizing medium. After immersion, mean mineral loss before and after remineralization of each specimen was determined using micro-CT. Mean mineral gain after remineralization was calculated. Calcium binding properties were measured by Isothermal titration calorimetry (ITC). TEM and Fourier transform-infrared were used to determine the effects of the peptide on calcium phosphate mineralization.

Results: A significant decrease in mineral loss after remineralization process in all groups was observed (p < 0.05). Treatment in remineralizing medium resulted in the lowest mineral gain while the fluoridated treatment exhibited the highest mineral gain among all groups. Inclusion of synthetic peptide in the remineralizing medium exhibited a higher mineral gain and the gain of 50 μg/mL group was greater than that of the 25 μg/mL group. No significant difference in mineral gain was observed between the remineralizing medium only group and the 12.5 μg/mL peptide group (p > 0.05). ITC values showed that the Ca²⁺-binding affinity of the peptide is about 9.914 × 10⁴M⁻¹. Furthermore, the peptide was found to inhibit calcium phosphate precipitation and stabilize amorphous calcium phosphate formation for more than 2 h and finally transform into ordered hydroxyapatite crystals.

Conclusion: Specific concentrations of the amelogenin-based synthetic peptide promoted in vitro remineralization, with higher concentrations exhibiting significantly greater remineralization. This study presented evidence suggesting that the peptide may act as a Ca²⁺carrier as well as a regulating factor. When the stabilizing calcium and phosphorus ions bind with the peptide they become biologically available for the remineralization of deeper carious lesions, while also regulated by the peptide to transform into ordered hydroxyapatite crystals.

Galla chinensis Compounds Remineralize Enamel Caries Lesions in a Rat Model

OBJECTIVES

To investigate the effect of Galla chinensis chemical compounds on enamel caries remineralization in rats.

METHODS

A total of 40 rats were inoculated with Streptococcus sobrinus 6715 and fed a cariogenic diet (Keyes 2000). The rats were randomly divided into 4 groups and treated topically twice a day with each of the following extracts (or control) for 5 weeks: distilled and deionized water (DDW, negative control); 1,000 ppm NaF (positive control); 4,000 ppm G. chinensis crude aqueous extract (GCE), or 4,000 ppm gallic acid (GA). After the experimental period, Keyes' caries diagnosis and scoring technique was applied as a preliminary evaluation on the molar teeth. For more accurate remineralization data, the residual enamel volume of the first molar and the mineral density (MD) of the enamel were further analyzed by micro-CT.

RESULTS

The severity of molar enamel caries decreased in the following order of treatment groups: DDW > GA > GCE > NaF (p < 0.05). In addition, the residual first molar enamel volume and MD values increased in the order of DDW, GA, GCE and NaF treatment groups (p < 0.05). In most molars, remineralization layers were observed on the surface of lesions.

CONCLUSION

G. chinensis compounds remineralize enamel caries lesions in a rat model.