Effect of gels containing chlorhexidine or epigallocatechin-3-gallate on the protein composition of the acquired enamel pellicle

In vivo modification of the enamel pellicle and saliva resveratrol levels after use of resveratrol-containing orodispersible capsules

OBJECTIVES

To evaluate in vivo 1) the bioavailability of trans-resveratrol when administered through sublingual capsules; 2) the effect of resveratrol on the protein composition of the acquired enamel pellicle (AEP).

DESIGN

Ten volunteers received a sublingual capsule containing 50 mg of trans-resveratrol. Unstimulated saliva was then collected after 0, 30, 60, and 120 min and AEP was collected after 120 min following administration of the capsule. In the next week, the volunteers received a placebo sublingual capsule, and saliva and AEP were collected again. Saliva samples were analyzed for free trans-resveratrol using high-performance liquid chromatopgraphy (HPLC), and AEP samples were subjected to proteomic analysis (nLC-ESI-MS/MS).

RESULTS

Trans-resveratrol was detected in saliva at all the time points evaluated, with the peak at 30 min. A total of 242 proteins were identified in both groups. Ninety-six proteins were increased and 23 proteins were decreased in the Resveratrol group. Among the up-regulated proteins, isoforms of cystatins, PRPs, Mucin-7, Histatin-1, Lactotrasnferrin and Lysozyme-C were increased and the isoforms of Protein S100, Neutrophil defensins, Albumin, PRPs, and, Statherin were decreased in Resveratrol group.

CONCLUSION

The sublingual capsule is effective at increasing the bioavailability of trans-resveratrol in saliva. Several proteins involved in important processes to maintain systemic and oral health homeostasis were identified. These proteins differently expressed due to the presence of trans-resveratrol deserve attention for future studies, since they have important functions, mainly related to antimicrobial action.

Increase in plasma resveratrol levels and in acid-resistant proteins in the acquired enamel pellicle after use of resveratrol-containing orodispersible tablets

OBJECTIVE

This study evaluated the effect of administration of trans-resveratrol-containing orodispersible tablets on the protein composition of the AEP and on blood plasma trans-resveratrol concentrations.

METHODS

Ten volunteers participated in two crossover double-blind phases. In each phase, after dental prophylaxis, they received a trans-resveratrol (15 mg) orodispersible tablet, or a placebo tablet (without actives). The AEP formed after 120 min was collected with electrode filter papers soaked in 3 % citric acid. Blood samples were collected 30, 45, 60 and 120 min after the use of the tablet. After protein extraction, AEP samples were analyzed by shotgun labelfree quantitative proteomics and plasma samples were analyzed by high-performance liquid chromatography (HPLC).

RESULTS

Eight hundred and two proteins were identified in the AEP. Among them, 336 and 213 were unique to the trans-resveratrol and control groups, respectively, while 253 were common to both groups. Proteins with important functions in the AEP had increased expression in the trans-resveratroltreated group, such as neutrophil defensins, S100 protein isoforms, lysozyme C, cystatin-D, mucin-7, alphaamylase, albumin, haptoglobin and statherin. Trans-resveratrol was detected in the plasma at all the times evaluated, with the peak at 30 min.

CONCLUSIONS

The administration of trans-resveratrol in sublingual orodispersible tablets was effective both to increase the bioavailability of the polyphenol and the expression of antibacterial and acid-resistant proteins in the AEP, which might benefit oral and general health.

A new role for resveratrol: Protection of enamel against erosion

OBJECTIVE

The aim of this study was to determine the effect of different concentrations of resveratrol in protecting enamel against initial dental erosion in vitro.

METHODS

Ninety bovine enamel samples (4 × 4 mm) were divided into six groups: Phosphate buffered saline (negative control; PBS), Commercial solution (Elmex Erosion Protection™; positive control) and resveratrol at 4 different concentrations (1, 10, 100 or 400 µg/mL). Initially, the samples were incubated in saliva for the formation of the acquired pellicle (250 µL, 1 h, 37 °C, 250 rpm). Afterward, the samples were incubated in the respective treatments (250 µL, 1 min, 37 °C, 250 rpm) and then reincubated in saliva (250 µL, 1 h, 37 °C, 250 rpm). Finally, the samples were subjected to an erosive challenge by incubating in 1 % citric acid (1 mL, pH 3.5, 1 min, 25 °C, 250 rpm). The percentage surface microhardness change (% SMC) was assessed using a microhardness tester. Data were analyzed by Kruskal-Wallis and Dunn's tests (p < 0.05).

RESULTS

The treatments with Elmex™ and resveratrol (1, 10 and 100 µg/mL) significantly protected enamel compared to the negative control, without significant differences among them. However, the group treated with the highest resveratrol concentration (400 µg/mL) did not show a significant difference from the negative control.

CONCLUSIONS

Resveratrol at concentrations ranging from 1 to 100 µg/ml was effective in preventing loss of enamel surface microhardness.

CLINICAL SIGNIFICANCE

This result suggests a potential new direction for the development of dental products based on resveratrol for the prevention of dental erosion.

Comparative evaluation of propolis mouthwash with 0.2% chlorhexidine mouthwash as an adjunct to mechanical therapy in improving the periodontitis among perimenopausal women: a randomized controlled trial

OBJECTIVE

To evaluate the efficacy of Propolis mouthwash compared to chlorhexidine mouthwash as an adjunct to mechanical therapy in improving clinical parameters in perimenopausal women with chronic periodontitis.

METHODOLOGY

A double-blind, randomized, controlled clinical trial was conducted by recruiting 144 subjects with mild to moderate chronic periodontitis. After scaling and root planning, subjects were allocated to two treatment groups: 0.2% chlorhexidine mouthwash and 20% propolis mouthwash twice daily for six weeks. Clinical parameters such as pocket probing depth (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP) were analysed at baseline, six weeks, and 12 weeks.

RESULT

The mean value of PPD in the propolis group was 4.67 at baseline, reduced to 4.01 at six weeks and 3.59 at 12 weeks. While in the chlorhexidine group, the baseline value of 4.65 reduced to 4.44 and 4.25 at six weeks and 12 weeks, respectively. The baseline value of the mean CAL in the propolis group was 4.45. This value was reduced to 4.15 at six weeks and 3.77 at 12 weeks. For the chlorhexidine group, the baseline value of CAL was 4.80, which was reduced to 4.50 and 4.19 at six weeks and 12 weeks. The mean value of bleeding on probing in the propolis group was 77.20, which decreased to 46.30 at six weeks and 14.60 at the final visit. In the chlorhexidine group, the mean value of 77.30 was reduced to 49.60 and 22.80 at subsequent visits.

CONCLUSION

This study concludes that both propolis and chlorhexidine mouthwash positively improve clinical parameters; however, propolis is significantly more effective in improving BOP.

TRIAL REGISTRATION

ID: NCT05870059, Date of Registration: 02/02/2022. ( https://beta.

CLINICALTRIALS

gov/study/NCT05870059 ).

Prevention of Dental Biofilm Formation with Polyphenols: A Systematic Review

Polyphenols are plant secondary products with health-promoting properties against various degenerative or infectious diseases, and thus may help in the prevention of oral diseases. The aim of the present systematic review was to investigate polyphenols as a possible adjuvant in inhibiting dental biofilm formation, which is an important precondition for the most prevalent oral disease - caries and periodontitis. A literature search was conducted using the databases PubMed, CENTRAL and Scopus. Only studies with oral healthy participants and plaque level as outcome were included. Data search and extraction was conducted by two authors independently. Of the 211 initially identified studies, only six met all inclusion criteria. Meta-analysis was performed with five studies using the random effect model. Treatment with polyphenols reduced the plaque level in comparison to a negative control, but not significantly. Strong evidence of heterogeneity was observed. The diversity and complexity of polyphenols and their preparation need to be considered. There is no clear evidence that clinical use of polyphenols can prevent dental biofilm formation. Additional research with more and larger randomized controlled trials are required.

Plant extracts have dual mechanism on the protection against dentine erosion: action on the dentine substrate and modification of the salivary pellicle

To investigate the effect of some polyphenol-rich plant extracts on the protection of dentine against demineralization, both acting on the dentine and on the salivary pellicle. Dentine specimens (n = 180) were randomly distributed into 6 experimental groups (n = 30/group): Control (deionized water), Açaí extract, Blueberry extract, Green tea extract, Grape seed extract, and Sn²⁺/F^- (mouthrinse containing stannous and fluoride). Each group was further divided into two subgroups (n = 15), according to the site of action of the substance: on the dentine surface (D) or on the salivary pellicle (P). The specimens were submitted to 10 cycles: 30 min incubation in human saliva (P) or only in humid chamber (D), 2 min immersion in experimental substances, 60 min of incubation in saliva (P) or not (D), and 1 min erosive challenge. Dentine surface loss (DSL), amount of degraded collagen (dColl) and total calcium release were analyzed. Green tea, Grape seed and Sn²⁺/F^- showed significant protection, with least DSL and dColl. The Sn²⁺/F^- showed better protection on D than on P, whereas Green tea and Grape seed showed a dual mode of action, with good results on D, and even better on P. Sn²⁺/F^- showed the lowest values of calcium release, not differing only from Grape seed. Sn²⁺/F^- is more effective when acting directly on the dentine surface, while Green tea and Grape seed have a dual mode of action: with a positive effect on the dentine surface itself, but an improved efficacy in the presence of the salivary pellicle. We further elucidate the mechanism of action of different active ingredients on dentine erosion, where Sn²⁺/F^- acts better on the dentine surface, but plant extracts have a dual mode of action, acting on the dentine itself as well as on the salivary pellicle, improving the protection against acid demineralization.

Olive Oil as a Transport Medium for Bioactive Molecules of Plants?-An In Situ Study

(1) Caries and erosions still remain a challenge for preventive dentistry. Certain plant extracts have shown beneficial effects in preventive dentistry. The aim of this study was to evaluate the antibacterial, anti-adherent and erosion-protective properties of ellagic acid (EA) as a polyphenolic agent. The combination with olive oil was investigated additionally to verify a possible improved bioactive effect of EA. (2) An in situ study was carried out with six subjects. Individual splints were prepared with bovine enamel specimens. The splints were worn for 1 min (pellicle formation time). Thereafter, 10 min rinses were performed with EA in water/in oil. Bacterial adherence was evaluated by fluorescence microscopy (DAPI, ConA, BacLight) after an 8 h oral exposition time. Additionally, the splints were worn for 30 min to quantify demineralization processes. The ultrastructure of the pellicle was investigated after an oral exposure time of 2 h under a transmission electron microscope. Statistical analysis was performed by Kruskal-Wallis tests, Mann-Whitney U tests and Bonferroni-Holm correction. (3) Rinsing with EA led to a significant reduction of adherent vital and dead bacteria. The combination with olive oil did not improve these outcomes. The assessment of glucan structures after rinsing with EA in water showed significant effects. Significant differences were observed for both rinses in calcium release at pH 3.0. After rinsing with EA in oil, significantly less calcium was released compared to rinsing with EA in water (pH = 3.0). (4) Olive oil is not suitable as a transport medium for lipophilic polyphenols. EA has anti-adherent and antibacterial properties in situ. EA also shows erosion-protective effects, which can be enhanced in combination with olive oil depending on the pH value. Ellagic acid has a neutral pH and could be an opportunity in the treatment of specific patient groups (xerostomia or mucositis).

New insights into the protective effect of statherin-derived peptide for different acquired enamel pellicle formation times on the native human enamel surfaces

OBJECTIVES

This study evaluated the protective impact of acquired enamel pellicle (AEP) engineering with statherin-derived peptide (StatpSpS), considering different AEP formation times.

DESIGN

A total of 120 native human enamel specimens were divided into 2 main groups: 1) No AEP engineering and 2) AEP engineering with StatpSpS (pretreatment for 1 min; 37 °C, under agitation). Each group was further divided into 4 subgroups: No pellicle, or 1, 60-and-120 min AEP formation times (human saliva; 37 °C). The specimens were then subjected to an erosive challenge (1% citric acid; pH 3.6; 1 min; 25 °C). This procedure was repeated for 5 cycles. Relative surface reflection intensity (%SRI) was measured and scanning electron microscopy (SEM) of the enamel surface was done.

RESULTS

All AEP engineering groups protected against initial dental erosion in comparison with No pellicle (p < 0.001), likewise all groups with AEP, independent of engineering or formation times (p 0.001). Furthermore, engineering with StatpSpS even without the presence of AEP protected the enamel when compared to the No engineering/No pellicle group (p < 0.0001). No difference was observed regarding the protection from the different AEP formation times (p > 0.05). Regarding the SEM analysis, in the "No AEP engineering & No AEP" group, a more severe effect of citric acid was observed, with more enamel prism heads and scratches on the surface when compared with the other groups.

CONCLUSIONS

AEP provides almost instant protection at formation times even as short as 1 min, protecting the native enamel against erosion. Treatment with StatpSpS by itself provides similar protection as the AEP.

Dual protective effect of the association of plant extracts and fluoride against dentine erosion: In the presence and absence of salivary pellicle

OBJECTIVES

To verify the protective effect of plant extracts associated with fluoride against dental erosion of dentine, in the presence and absence of a salivary pellicle.

METHODS

Dentine specimens (n = 270) were randomly distributed into 9 experimental groups (n = 30/group): GT (green tea extract); BE (blueberry extract); GSE (grape seed extract); NaF (sodium fluoride); GT+NaF (green tea extract and NaF); BE+NaF (blueberry extract and NaF); GSE+NaF (grape seed extract and NaF); negative control (deionized water); and a positive control (commercialized mouthrinse containing stannous and fluoride). Each group was further divided into two subgroups (n = 15), according to the presence (P) or absence (NP) of salivary pellicle. The specimens were submitted to 10 cycles: 30 min incubation in human saliva (P) or only in humid chamber (NP), 2 min immersion in experimental solutions, 60 min of incubation in saliva (P) or not (NP), and 1 min erosive challenge. Dentine surface loss (dSL-10 and dSL-total), amount of degraded collagen (dColl) and total calcium release (CaR) were evaluated. Data were analyzed with Kruskal-Wallis, Dunn's and Mann-Whitney U tests (p>0.05).

RESULTS

Overall, the negative control presented the highest values of dSL, dColl and CaR, and the plant extracts showed different degrees of dentine protection. For the subgroup NP, GSE showed the best protection of the extracts, and the presence of fluoride generally further improved the protection for all extracts. For the subgroup P, only BE provided protection, while the presence of fluoride had no impact on dSL and dColl, but lowered CaR. The protection of the positive control was more evident on CaR than on dColl.

CONCLUSION

We can conclude that the plant extracts showed a protective effect against dentine erosion, regardless of the presence of salivary pellicle, and that the fluoride seems to improve their protection.

Topical Agents for Nonrestorative Management of Dental Erosion: A Narrative Review

A nonrestorative approach to the management of dental erosion is the foremost option: controlling dental erosion. The objectives of this study are to provide an overview and to summarise the effects and properties of topical anti-erosive agents as a nonrestorative treatment of dental erosion. A literature search was conducted on five databases of peer-reviewed literature—Cochrane Library, EMBASE, PubMed, Scopus and Web of Science—to recruit articles published between 1 January 2000 and 31 December 2021. The literature search identified 812 studies; 95 studies were included. Topical anti-erosive agents can be broadly categorised as fluorides, calcium phosphate-based agents, organic compounds and other anti-erosive agents. In the presence of saliva, fluorides promote the formation of fluorapatite on teeth through remineralisation. Calcium phosphate-based agents supply the necessary minerals that are lost due to the acid challenge of erosion. Some organic compounds and other anti-erosive agents prevent or control dental erosion by forming a protective layer on the tooth surface, by modifying salivary pellicle or by inhibiting the proteolytic activity of dentine collagenases. Topical anti-erosive agents are promising in managing dental erosion. However, current evidence shows inconsistent or limited results for supporting the use of these agents in clinical settings.

Preventive Applications of Polyphenols in Dentistry-A Review

Polyphenols are natural substances that have been shown to provide various health benefits. Antioxidant, anti-inflammatory, and anti-carcinogenic effects have been described. At the same time, they inhibit the actions of bacteria, viruses, and fungi. Thus, studies have also examined their effects within the oral cavity. This review provides an overview on the different polyphenols, and their structure and interactions with the tooth surface and the pellicle. In particular, the effects of various tea polyphenols on bioadhesion and erosion have been reviewed. The current research confirms that polyphenols can reduce the growth of cariogenic bacteria. Furthermore, they can decrease the adherence of bacteria to the tooth surface and improve the erosion-protective properties of the acquired enamel pellicle. Tea polyphenols, especially, have the potential to contribute to an oral health-related diet. However, in vitro studies have mainly been conducted. In situ studies and clinical studies need to be extended and supplemented in order to significantly contribute to additive prevention measures in caries prophylaxis.

Radiotherapy changes acquired enamel pellicle proteome in head and neck cancer patients

OBJECTIVES

To evaluate in vivo the proteomic profile of the acquired enamel pellicle (AEP) in patients with head and neck cancer (HNC) before, during and after radiotherapy.

METHODS

Nine patients, after prophylaxis, had their AEPs collected before (BRT), during (DRT; 2-5 weeks) and after (ART; 3-4 months) radiotherapy. AEP was also collected from nine healthy patients (Control). The proteins were extracted in biological triplicate and processed by label-free proteomics.

RESULTS

Statherin was increased more than 9-fold and several hemoglobin subunits were increased more than 5-fold DRT compared to BRT, while lactotransferrin, proline-rich proteins, cystatins, neutrophil defensins 1 and 3 and histatin-1 were decreased. ART, there was an increase in lactotransferrin and several isoforms of histones, while statherin and alpha-amylase proteins were decreased. MOAP-1 was exclusively found ART in comparison to BRT. When compared to Control, AEP of patients BRT showed an increase in proteins related to the perception of bitter taste, mucin-7 and alpha-amylases, while cystatin-S was decreased.

CONCLUSIONS

HNC and radiotherapy remarkably altered the proteome of the AEP. Antibacterial and acid-resistant proteins were decreased during radiotherapy.

CLINICAL SIGNIFICANCE

Our results provide important information for designing more effective dental products for these patients, in addition to contributing to a better understanding of the differential protective roles of the AEP proteins during radiotherapy. Moreover, some proteins identified in the AEP after radiotherapy may serve as prognostic markers for survival of HNC patients.

Salivary pellicle modification with polyphenol-rich teas and natural extracts to improve protection against dental erosion

OBJECTIVE

To investigate the modification of the salivary pellicle with different polyphenol-rich teas and natural extracts for the protection against dental erosion.

METHODS

We performed two experiments: one with teas (Green tea, Black tea, Peppermint tea, Rosehip tea, negative control [NC]) and other with natural extracts (Grape seed, Grapefruit seed, Cranberry, Propolis, NC), where NC was deionized water. A total of 150 enamel specimens were used (n = 15/group). Both experiments followed the same design, consisting of 5 cycles of: salivary pellicle formation (30 min, 37 °C), modification with the solutions (30 min, 25 °C), further salivary pellicle formation (60 min, 37 °C) and erosive challenge (1 min, 1% citric acid, pH 3.6). Relative surface microhardness (rSMH), relative surface reflection intensity (rSRI) and amount of calcium release (CaR) were evaluated. Data were analysed with Kruskal-Wallis and Wilcoxon rank sum tests with Bonferroni correction (α = 0.05).

RESULTS

Regarding teas, Black and Green teas showed the best protection against dental erosion, presenting higher rSMH and lower CaR than NC. Peppermint tea was not different to NC and Rosehip tea caused erosion, showing the highest CaR and greatest loss of SMH and SRI. Regarding natural extracts, Grape seed and Grapefruit seed extracts presented the best protective effect, with significantly higher rSMH and lower CaR. Cranberry caused significantly more demineralization; and Propolis did not differ from NC.

CONCLUSION

Green tea, Black tea, Grape seed extract and Grapefruit seed extract were able to modify the salivary pellicle and improve its protective effect against enamel erosion, but Rosehip tea and Cranberry extract caused erosion.

CLINICAL RELEVANCE

Some some bio-products, such as teas and natural extracts, improve the protective effect of the salivary pellicle against enamel erosion. More studies should be performed in order to test the viability of their use as active ingredients for oral care products.

IL-4 absence triggers distinct pathways in apical periodontitis development

Dental pulp is a specialized tissue able to respond to infectious processes. Nevertheless, infection progress and root canal colonization trigger an immune-inflammatory response in tooth-surrounding tissues, leading to apical periodontitis and bone tissue destruction, further contributing to tooth loss. In order to shed some light on the effects of IL-4 on periradicular pathology development modulation, microtomographic, histological and proteomic analyses were performed using 60 mice, 30 wild type and 30 IL-4^-/^-. For that, 5 animals were used for microtomographic and histological analysis, and another 5 for proteomic analysis for 0, 7 and 21 days with/without pulp exposure. The periapical lesions were established in WT and IL-4^-/^- mice without statistical differences in their volume, and the value of p < 0.05 was adopted as significant in microtomographic and histological analyses. Regarding histological analysis, IL-4^-/^- mice show aggravation of pulp inflammation compared to WT. By using proteomic analysis, we have identified 32 proteins with increased abundance and 218 proteins with decreased abundance in WT animals after 21 days of pulp exposure, compared to IL-4^-/^- animals. However, IL-4^-/^- mice demonstrated faster development of apical periodontitis. These animals developed a compensatory mechanism to overcome IL-4 absence, putatively based on the identification of upregulated proteins related to immune system signaling pathways. Significance: IL-4 might play a protective role in diseases involving bone destruction and its activity may contribute to host protection, mainly due to its antiosteoclastogenic action.

Could applying gels containing chlorhexidine, epigallocatechin-3-gallate, or proanthocyanidin to control tooth wear progression improve bond strength to eroded dentin?

STATEMENT OF PROBLEM

A consensus on whether or how to treat eroded dentin to bond to composite resins is lacking. The role of gels containing chlorhexidine (CHX), epigallocatechin-3-gallate (EGCG), and proanthocyanidin (PAC) in controlling erosive wear progression needs to be evaluated for bonding.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of gels containing antiproteolytic agents (CHX or EGCG) or an antiproteolytic and also collagen crosslinking agent (PAC) to control tooth wear progression on the microtensile bond strength (μTBS) of an adhesive system plus a composite resin to simulated eroded dentin.

MATERIAL AND METHODS

Superficial occlusal dentin surfaces obtained from sectioned third molars were ground with SiC paper (600-grit; 1 minute; N-normal dentin) or subsequently submitted to an initial erosive challenge (Coca-Cola; 5 minutes). They then received one of the following treatments: application of a placebo (P), a 0.12% CHX digluconate, an EGCG at 400 μM, or a 10% PAC gel (vehicle: hydroxyethylcellulose, propylene glycol, methylparaben, imidazolidinyl urea, and deionized water; active principle: as per the experimental groups when applicable) or no treatment (C: control). Initially demineralized dentin was also submitted to pH cycling (Coca-Cola; 5 minutes, 3×/day, 5 days) to simulate eroded dentin (E). After acid etching all the specimens, adhesive Adper Single Bond 2 was applied, and composite resin (Filtek Z350 XT) was placed. After 24 hours storage in distilled water at 37 °C, the specimens were sectioned into beams, and the μTBS was tested at 0.5 mm/minute. The μTBS values obtained were evaluated considering each tooth as an experimental unit, and 2-way ANOVA and the Tukey post hoc test for multiple comparisons were applied (α=.05).

RESULTS

Immediate μTBS values for the eroded dentin were always lower than those for the normal dentin, irrespective of whether any of the gels were applied for wear control.

CONCLUSIONS

CHX, EGCG, PAC, and placebo gels, applied after the initial demineralization and before the pH cycling to simulate the eroded dentin, had a similar effect on the μTBS of the adhesive system plus the composite resin to simulated eroded dentin when compared with nonapplication (control).

Dentifrices or gels containing MMP inhibitors prevent dentine loss: in situ studies

OBJECTIVES

Evaluate the effect of dentifrices or gels containing MMP inhibitors on dentine loss in situ.

MATERIALS AND METHODS

Acrylic palatal appliances containing bovine dentine blocks were divided into two rows, corresponding to the groups erosion (ERO) and erosion associated with abrasion (ERO+ABR). For ERO, the appliances were immersed in a cola drink for 5 min, 4 times/day, while for ERO+ABR, the blocks were brushed for 15 sec with a dentifrice slurry after the second and third erosive challenges. Ten volunteers took part in study 1 (S1), where the dentifrices evaluated contained 1100 ppm fluoride as NaF, 0.61% green tea extract, or 0.012% chlorhexidine digluconate. Thirteen volunteers participated in study 2 (S2), in which the treatment was performed only once (1 min) with gels containing 400 μM EGCG (EGCG400), 0.012% chlorhexidine, 1 mM FeSO₄, 1.23% F (NaF), placebo, or received no treatment. Dentine loss was analyzed by profilometry (μm).

RESULTS

Regarding S1, ERO+ABR induced significantly higher dentine loss compared with ERO and all dentifrices tested led to significantly lower dentine loss when compared with placebo. For S2, regardless of the conditions or times of evaluation, gels containing EGCG, CHX, or FeSO₄ led to significantly less wear compared with the other groups.

CONCLUSION

Both dentifrices and gels containing MMP inhibitors significantly reduced dentine loss.

CLINICAL RELEVANCE

Dentifrices and gels containing MMP inhibitors are able to increase the protection against dentine wear, although gels have a better effect when compared with fluoride gel, lasting up to 10 days after a single application.

Optimizing the formation of the acquired enamel pellicle in vitro for proteomic analysis

Saliva is the major contributor for the protein composition of the acquired enamel pellicle (AEP), a bacteria-free organic layer formed by the selective adsorption of salivary proteins on the surface of the enamel. However, the amount of proteins that can be recovered is even smaller under in vitro condition, due to the absence of continuous salivary flow.

Chlorhexidine rinsing inhibits biofilm formation and causes biofilm disruption on dental enamel in situ

OBJECTIVES

This in situ study aims to evaluate the effects of chlorhexidine (CHX) mouth rinsing on biofilm formation and moreover on the disruption of existing mature dental biofilms.

METHODS

Biofilms were formed in situ by five volunteers on bovine enamel specimens fixed to individual acrylic splints. For biofilm formation analysis, the volunteers intraorally exposed the splint for 48 h. Mouth rinsing using 10 ml of 0.2% CHX or water as control was performed for 30 s every 12 h. For analysis of biofilm disruption, the biofilm was formed on enamel specimens for 48 h. Then, the first CHX rinse was carried out. A second rinse followed after an additional 12 h, again for 30 s using 10 ml of 0.2% CHX. Biofilm vitality was imaged by fluorescence microscopy after vital fluorescence staining. Additionally, the ultrastructure of the biofilm was examined by transmission electron microscopy.

RESULTS

Rinses with 0.2% CHX significantly reduced biofilm formation on enamel. Both biofilm colonization and vitality were dramatically impaired. Moreover, a considerable biofilm disruption induced by the CHX rinses was observed. Remarkably, a single application of CHX to a 48-h mature biofilm causes biofilm ultrastructure alterations and induces a substantial reduction in biofilm thickness and bacterial vitality.

CONCLUSIONS

CHX mouth rinses induced a significant inhibition of biofilm formation on native enamel. Furthermore, an important biofilm disrupting effect under in situ conditions was detected.

CLINICAL RELEVANCE

CHX rinses could be used as a short-term treatment protocol for biofilm management focused on patients unable to reach adequate oral hygiene.

The influence of fillers and protease inhibitors in experimental resins in the protein profile of the acquired pellicle formed in situ on enamel-resin specimens

OBJECTIVE

This study evaluated the influence of the addition of fillers and/or protease inhibitors [(epigallocatechin gallate - EGCG) or (chlorhexidine - CHX)] in experimental resins in the protein profile of the acquired pellicle (AP) formed in situ on enamel-resin specimens.

DESIGN

324 samples of bovine enamel were prepared (6 × 6 × 2 mm). The center of each sample was added with one of the following experimental resins (Bis-GMA+TEGDMA): no filler, no inhibitor (NF-NI); filler no inhibitor (F-NI); no filler plus CHX (NF-CHX); filler plus CHX (F-CHX); no filler plus EGCG (NF-EGCG); filler plus EGCG (F-EGCG). Nine subjects used a removable jaw appliance (BISPM - Bauru in situ pellicle model) with 2 slabs from each group. The AP was formed for 120 min, in 9 days and collected with electrode filter paper soaked in 3% citric acid. The pellicles collected were processed for analysis by LC-ESI-MS/MS.

RESULTS

A total of 140 proteins were found in the AP collected from all the substrates. Among them, 16 proteins were found in common in all the groups: 2 isoforms of Basic salivary proline-rich protein, Cystatin-S, Cystatin-AS, Cystatin-SN, Histatin-1, Ig alpha-1 chain C region, Lysozyme C, Mucin-7, Proline-rich protein 4, Protein S100-A9, Salivary acidic proline-rich phosphoprotein ½ and Statherin. Proteins with other functions, such as metabolism and transport, were also identified.

CONCLUSION

The composition of the experimental resins influenced the protein profile of the AP. This opens a new avenue for the development of new materials able to guide for AP engineering, thus conferring protection to the adjacent teeth.

Proteomic Analysis of the Initial Oral Pellicle in Caries-Active and Caries-Free Individuals

PURPOSE

To 1) elucidate individual proteomic profiles of the 3-min biofilm of caries-active and caries-free individuals and 2) compare these proteomic profiles against the background of caries.

EXPERIMENTAL DESIGN

The initial oral pellicle of 12 caries-active and 12 caries-free individuals is generated in situ on ceramics specimens. The individual, host-specific proteomic profiles of this basic pellicle layer are analyzed by a chemical elution protocol combined with an elaborate mass spectrometry and evaluated bioinformatically.

RESULTS

A total of 1188 different proteins are identified. Additionally, 68 proteins are present in the profiles of all individuals, suggesting them as ubiquitously occurring base-proteins of the initial human pellicle. Thereof, the single profiles exhibit high inter-individual differences independent of their group affiliation, stating the initial pellicle to represent a rather "individual fingerprint". Quantitative analyses imply slight indication for 23 proteins potentially capable of counting for caries-specific biomarkers.

CONCLUSIONS AND CLINICAL RELEVANCE

The introduced protocol enables the individual analysis of minimal protein amounts and allows for highly precise characterizations and comparisons of individual proteomic profiles. The results contain a considerable higher extent of protein identifications and might serve as a base for future large scale analyzes to identify discrimination factors for the development of caries susceptibility tests.

Proteomic analysis of the acquired enamel pellicle formed on human and bovine tooth: a study using the Bauru in situ pellicle model (BISPM)

OBJECTIVES

The acquired enamel pellicle (AEP) is an organic film, bacteria-free, formed in vivo as a result of the selective adsorption of salivary proteins and glycoproteins to the solid surfaces exposed to the oral environment. Objective: This study aimed to compare the proteomic profile of AEP formed in situ on human and bovine enamel using a new intraoral device (Bauru in situ pellicle model - BISPM).

MATERIAL AND METHODS

Material and Methods: One hundred and eight samples of human and bovine enamel were prepared (4×4 mm). Nine subjects with good oral conditions wore a removable jaw appliance (BISPM) with 6 slabs of each substrate randomly allocated. The AEP was formed during the morning, for 120 minutes, and collected with an electrode filter paper soaked in 3% citric acid. This procedure was conducted in triplicate and the pellicle collected was processed for analysis by LC-ESI-MS/MS. The obtained mass spectrometry MS/MS spectra were searched against human protein database (SWISS-PROT).

RESULTS

Results: The use of BISPM allowed the collection of enough proteins amount for proper analysis. A total of 51 proteins were found in the AEP collected from the substrates. Among them, 15 were common to both groups, 14 were exclusive of the bovine enamel, and 22 were exclusive of the human enamel. Proteins typically found in the AEP were identified, such as Histatin-1, Ig alpha-1, Ig alpha 2, Lysozyme C, Statherin and Submaxillary gland androgen-regulated protein 3B. Proteins not previously described in the AEP, such as metabolism, cell signaling, cell adhesion, cell division, transport, protein synthesis and degradation were also identified.

CONCLUSIONS

Conclusion: These results demonstrate that the proteins typically found in the AEP appeared in both groups, regardless the substrate. The BISPM revealed to be a good device to be used in studies involving proteomic analysis of the AEP.

Changes in the Proteomic Profile of Acquired Enamel Pellicles as a Function of Their Time of Formation and Hydrochloric Acid Exposure

Objective: Changes in the protein profile of acquired enamel pellicles (AEP) formed in vivo over different time periods were evaluated after the application of hydrochloric acid (HCl). Methods: Nine subjects were submitted to dental prophylaxis with pumice. After 3 or 120 min, the teeth were isolated with cotton rolls and 50 μL of 0.1 M HCl (pH 1.0), 0.01 M HCl (pH 2.0), or deionized water were applied on the buccal surface of the teeth for 10 s. The AEP was then collected using an electrode filter paper presoaked in 3% citric acid. After protein extraction, the samples were submitted to reverse-phase liquid chromatography coupled to mass spectrometry (nano LC-ESI-MS/MS). Label-free quantification was performed (Protein Lynx Global Service software). Results: A total of 180 proteins were successfully identified in the AEP samples. The number of identified proteins increased with the time of pellicle formation. Only 4 proteins were present in all the groups (isoforms of IgA, serum albumin, and statherin). The greatest number of proteins identified uniquely in one of the groups was obtained for the groups treated with HCl after 2 h of pellicle formation (approx. 50 proteins). Conclusion: Proteins resistant to removal by HCl, such as serum albumin and statherin, were identified even in the short-term AEP. In addition, 120-min pellicles present many proteins that are resistant to removal by HCl. This suggests an increase in protection against intrinsic acids with the time of pellicle formation, which should be evaluated in future studies.

Protein Profile of the Acquired Enamel Pellicle after Rinsing with Whole Milk, Fat-Free Milk, and Water: An in vivo Study

This study detected changes in the protein profile of the acquired enamel pellicle (AEP) formed in vivo after rinsing with whole milk, fat-free milk, or water. Nine subjects in good oral condition took part in the study. The acquired pellicle was formed in the morning, for 120 min, after prophylaxis with pumice. Following this, the volunteers rinsed with 10 mL of whole milk, fat-free milk, or deionized water for 30 s, following a blinded crossover protocol. After 60 min, the pellicle was collected with filter paper soaked in 3% citric acid and processed for analysis by liquid chromatography-electrospray ionization tandem mass spectrometry. The obtained tandem mass spectrometry spectra were searched against a human protein database (Swiss-Prot). The proteomic data related to protein quantification were analysed using the PLGS software. A total of 260 proteins were successfully identified in the AEP samples collected from all groups. Forty-nine were common to all 3 groups, while 72, 62, and 49 were specific to the groups rinsing with whole milk, fat-free milk, and water, respectively. Some were typical components of the AEP, such as cystatin-B, cystatin-SN, isoforms of α-amylase, IgA and IgG, lysozyme C, protein S100 A78, histatin-1, proline-rich protein 27, statherin, and lactotransferrin. Other proteins are not commonly described as part of the AEP but could act in defence of the organism against pathogens. Distinct proteomic profiles were found in the AEP after rinsing with whole or fat-free milk, which could have an impact on bacterial adhesion and tooth dissolution. The use of fat-free milk could favourably modulate the adhesion of bacteria to the AEP as well as biofilm formation when compared with whole milk.