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Alblooshi NA, Naseer TK, Bijle MN. Caries preventive potential of professionally deliverable fluoride-containing agents with incorporated arginine: A scoping review. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:154-162. [PMID: 38828462 PMCID: PMC11141041 DOI: 10.1016/j.jdsr.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/08/2023] [Accepted: 05/12/2024] [Indexed: 06/05/2024] Open
Abstract
The scoping review objectives were to: 1) investigate the caries preventive potential of professionally deliverable fluoride (F)-containing agents with incorporated arginine (Arg); and 2) identify the future scope of research on Arg-F interventions for caries prevention. Of 150 identified records, 7 articles (6 in vitro investigations and 1 scoping review) were included for a complete review; with no clinical studies with/without appraisal. Arginine variants (L-Arg/Arg.HCl at 1% to 10% w/v.) were examined for a potential professional application aimed at caries prevention, as reported with in vitro studies. Of the included articles, four in vitro studies explored L-Arg enriched 5% NaF varnish (Duraphat®) as a promising caries preventive agent, while only one considered incorporating L-Arg in MI varnish®/nanohydroxyapatite and one investigated glass ionomer cement for primary/secondary and tertiary caries prevention. The scoping review highlighted the scope for incorporating Arg to professionally deliverable F-containing agents. No clinical data are available to make conclusive recommendations about the caries preventive potential of professionally deliverable F-containing agents with incorporated Arg. With Arg-F varnish being investigated predominantly through in vitro studies, the data so far suggest that Arg was incorporated exclusively in Duraphat®, while the potential of Arg to prevent caries in other F-containing varnishes remains unexplored.
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Affiliation(s)
- Nouf Ali Alblooshi
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Tiba Kahtan Naseer
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Mohammed Nadeem Bijle
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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El Harram S, Sqalli T. Could the Arginine-Fluoride Association Have a Real Impact on Caries Prevention? Cureus 2024; 16:e72153. [PMID: 39575002 PMCID: PMC11581447 DOI: 10.7759/cureus.72153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2024] [Indexed: 11/24/2024] Open
Abstract
In the context of preventive therapy, fluoride has allowed the reduction of the incidence and prevalence of caries. The establishment of the protective role of arginine in the neutralization of plaque acids has led to the development of new arginine-fluorine associations to potentiate this preventive aspect. Studies have reported that this association could provide superior efficacy compared to fluoride alone. A synergistic effect that could be potential and thus represent a promising ecological approach for caries prevention. However, confirmation of the effective efficacy of the arginine-fluoride association requires additional clinical studies to be carried out before establishing recommendations.
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Affiliation(s)
- Sara El Harram
- Conservative Dentistry and Endodontics, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fes, MAR
| | - Tarik Sqalli
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fes, MAR
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Bijle MN, Abdalla MM, Yiu C. The effect of arginine on the growth of probiotics. J Dent 2024; 149:105272. [PMID: 39074576 DOI: 10.1016/j.jdent.2024.105272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/15/2024] [Accepted: 07/26/2024] [Indexed: 07/31/2024] Open
Abstract
OBJECTIVE(S) The study objective was to examine the effect of arginine (Arg) supplementation on the growth of probiotics. METHODS Lacticaseibacillus rhamnosus GG, Lactiplantibacillus plantarum, and Lactobacillus acidophilus were identified as potential probiotics. L. rhamnosus GG and L. plantarum were selected for further experimentation. The probiotics were co-treated with 0.9 % NaCl (negative control), 0.5 % Arg, and 1.0 % Arg in a 1:1 ratio for 24 h at 5 % CO2, 37 °C. The probiotics were tested for growth profiles, spectroscopic turbidity assay, metabolic assays (XTT and WST-8), live/dead cell assessment using confocal laser scanning microscopy (CLSM), and colony forming units (CFU). RESULTS The growth profiles of L. rhamnosus GG and L. plantarum were found to be similar, whereas L. acidophilus showed minimal or no transition from the initial lag phase. In the turbidity assay, the end-point absorbance for L. rhamnosus GG with 1.0 % Arg was significantly lower than 0.9 % NaCl and 0.5 % Arg (p < 0.05). For metabolic assays and CFU, increasing concentrations of Arg increased the viable cells for L. rhamnosus GG (p < 0.05), but decreased viability for L. plantarum (p < 0.05). Metabolic assays with dual-species bacterial suspensions indicated that Arg co-treatment inhibited viable proportions compared to control (p < 0.05). The dead cell proportion was significantly lower than live cell proportion for all tested interventions and probiotics (p < 0.05). CONCLUSION Increasing concentrations of Arg promote the growth of L. rhamnosus GG, while conversely inhibiting the growth of L. plantarum. Therefore, the effect of prebiotic Arg on probiotics is concentration-dependent, leading to a selective promotion or inhibition of growth. CLINICAL SIGNIFICANCE The present study results show that Arg supplementation can selectively enhance the growth of L. rhamnosus GG while inhibit the growth of L. plantarum. This underscores the need to consider strain-specific responses in probiotic formulations when developing Arg-based synbiotics for modulating biofilms and creating ecologically homeostatic biofilm microenvironments.
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Affiliation(s)
| | - Mohamed Mahmoud Abdalla
- Faculty of Dentistry, The University of Hong Kong, Hong Kong; Dental Biomaterials, Faculty of Dental Medicine Al-Azhar University, Cairo, Egypt
| | - Cynthia Yiu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Rini ADK, Juwita FT, Bagjana RW, Octivany S, Purnama RB, Rijal MS, Anwar AM, Purwasasmita BS, Asri LATW. Improving the Mechanical Properties of Glass Ionomer Cement With Nanocrystalline Cellulose From Rice Husk. J Biomed Mater Res B Appl Biomater 2024; 112:e35472. [PMID: 39215536 DOI: 10.1002/jbm.b.35472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 04/09/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
This study aimed to evaluate the effect of incorporating nanocrystalline cellulose (NCC) sourced from rice husk on the mechanical properties of a commercial glass ionomer cement (GIC). NCC was isolated through acid hydrolysis, and its crystallinity, chemical structure, and morphology were characterized through x-ray diffractometry, Fourier-transform infrared spectroscopy, and transmission electron microscopy, respectively. Various concentrations of NCC (0%, 0.5%, 1%, and 1.5%) were added to reinforce the GIC matrix. Mechanical tests including compressive strength, flexural strength, hardness, and shear bond strength were conducted on the modified GIC samples. The addition of NCC resulted in increased hardness and shear bond strength values, with 1% NCC showing the highest values compared to other concentrations. However, there was no significant improvement observed in the compressive and flexural strength of the modified GIC. Failure mode test revealed a reduction in adhesive failure with the addition of NCC. Incorporating small amounts of NCC (0.5%-1%) suggests a promising and affordable modification of GIC restorative material using biomass residue, resulting in improved mechanical properties.
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Affiliation(s)
- Aninda Dwi Kartika Rini
- Dental Medicine Study Program, Faculty of Medicine, Universitas Jendral Soedirman, Purwokerto, Indonesia
| | - Fifin Tresna Juwita
- Materials Science and Engineering Research Group, Faculty of Mechanical and Aerospace Engineering, Institut Teknologi Bandung, Bandung, Indonesia
| | - Riza Widyanti Bagjana
- Dental Medicine Study Program, Faculty of Medicine, Universitas Jendral Soedirman, Purwokerto, Indonesia
| | - Sherly Octivany
- Dental Medicine Study Program, Faculty of Medicine, Universitas Jendral Soedirman, Purwokerto, Indonesia
| | - Ryana Budi Purnama
- Dental Medicine Study Program, Faculty of Medicine, Universitas Jendral Soedirman, Purwokerto, Indonesia
| | - Moch Saifur Rijal
- Research Center for Nanoscience and Nanotechnology, Institut Teknologi Bandung, Bandung, Indonesia
| | - Ahmad Miftahul Anwar
- Materials Science and Engineering Research Group, Faculty of Mechanical and Aerospace Engineering, Institut Teknologi Bandung, Bandung, Indonesia
| | - Bambang Sunendar Purwasasmita
- Research Center for Nanoscience and Nanotechnology, Institut Teknologi Bandung, Bandung, Indonesia
- Engineering Physics Research Group, Faculty of Industrial Technology, Institut Teknologi Bandung, Bandung, Indonesia
| | - Lia A T W Asri
- Materials Science and Engineering Research Group, Faculty of Mechanical and Aerospace Engineering, Institut Teknologi Bandung, Bandung, Indonesia
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Bai X, Chen Y, Zhou T, Pow EHN, Tsoi JKH. The chemical and optical stability evaluation of injectable restorative materials under wet challenge. J Dent 2024; 146:105031. [PMID: 38710315 DOI: 10.1016/j.jdent.2024.105031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/08/2024] [Accepted: 04/27/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVES To investigate and compare the chemical and optical stability of four restorative composite materials: two injectable resins, one flowable resin and one compomer. METHODS Two injectable nano-filled composite resins: G-aenial Universal (GU) and Beautifil Injectable XSL (BI), a flowable composite resin: Filtek Supreme Flowable (FS) and a compomer: Dyract Flow (DF), in A2 shade were tested and compared. Water sorption and solubility were conducted according to ISO4049:2019 standard; ICP-OES and F-ion selective electrode were used to test the elemental release; Degree of conversion (DC) was obtained by using FTIR; water contact angle was obtained by static sessile drop method, and a spectrophotometer was used for optical properties (ΔE⁎, ΔL⁎ and TP). SPSS 28.0 was used for statistical analysis and the significant level was pre-set as α = 0.05. RESULTS GU performed the best in water sorption and solubility, FS had the lowest elemental release, the best colour stability, and the highest DCIM and DC24-h. DF, the compomer had the lowest, and GU and BI, the injectable composites had the largest water contact angle, respectively. Correlations were found between water sorption and water solubility. CONCLUSIONS The four composite restorative materials showed different chemical and optical behaviours. Overall, composite resins performed better than compomer, while additional laboratory and in vivo tests are necessary to obtain a more comprehensive comparison between injectable and flowable composite resins. Wsp and Wsl are influenced by many common factors, and the values are highly positively related. CLINICAL SIGNIFICANCE A comprehensive understanding of materials is crucial before selecting materials for clinical practice. Composite resins rather than compomers are recommended because of their exceptional properties, which make them eligible for a wide range of clinical applications and an elongated lifespan.
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Affiliation(s)
- Xuedong Bai
- Dental Materials Science, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China
| | - Yanning Chen
- Dental Materials Science, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China
| | - Tianyu Zhou
- Dental Materials Science, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China
| | - Edmond Ho Nang Pow
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China
| | - James Kit Hon Tsoi
- Dental Materials Science, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China.
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An J, Shen X, Peng T, Qiao M, Xu B. Formulation of arginine-loaded mesoporous silica nanoparticles (Arg@MSNs) modified orthodontic adhesive. J Dent 2024; 145:104992. [PMID: 38599563 DOI: 10.1016/j.jdent.2024.104992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/04/2024] [Accepted: 04/06/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVES The objective of this study was to synthesize arginine loaded mesoporous silica nanoparticles (Arg@MSNs), develop a novel orthodontic adhesive using Arg@MSNs as modifiers, and investigate the adhesive performance, antibacterial activity, and biocompatibility. METHODS Arg@MSNs were synthesized by immobilizing arginine into MSNs and characterized using transmission electron microscope (TEM), dynamic light scattering (DLS), and Fourier Transform Infrared Spectrometer (FT-IR). Arg@MSNs were incorporated into Transbond XT adhesive with different mass fraction to form functional adhesives. The degree of conversion (DC), arginine release behavior, adhesive performance, antibacterial activity against Streptococcus mutans biofilm, and cytotoxicity were comprehensively evaluated. RESULTS TEM, DLS, and FT-IR characterizations confirmed the successful preparation of Arg@MSNs. The incorporation of Arg@MSNs did not significantly affect DC and exhibited clinically acceptable bonding strength. Compared to the commercial control, the Arg@MSNs modified adhesives greatly suppressed the metabolic activity and polysaccharide production while increased the biofilm pH values. The cell counting kit (CCK)-8 test indicated no cytotoxicity. CONCLUSIONS The novel orthodontic adhesive containing Arg@MSNs exhibited significantly enhanced antibacterial activities and inhibitory effects on acid production compared to the commercial adhesive without compromising their bonding strength or biocompatibility. CLINICAL SIGNIFICANCE The novel orthodontic adhesive containing Arg@MSNs exhibits potential clinical benefits in preventing demineralization of enamel surfaces around or beneath orthodontic brackets due to its enhanced antibacterial activities and acid-producing inhibitory effects.
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Affiliation(s)
- Jiali An
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China
| | - Xiao Shen
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China
| | - Tianhao Peng
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China; Peking Union Medical College Hospital, Peking Union Medical College, Beijing 100193, China
| | - Min Qiao
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China.
| | - Baohua Xu
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China; Peking Union Medical College Hospital, Peking Union Medical College, Beijing 100193, China.
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Alblooshi NA, Krithikadatta J, Yiu C, Bijle MN. Fluoride release potential of arginine-incorporated fluoride varnishes. Dent Mater J 2024; 43:146-154. [PMID: 38233188 DOI: 10.4012/dmj.2023-238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
The study aimed to examine the fluoride (F) release potential of arginine (Arg)-incorporated F varnishes. Four commercially available F varnishes were included in the study: Duraphat® (5% NaF), Flúor Protector® (0.9% SiH2F2), Fluor Protector S® (NH4F), and Fluorimax™ (2.5% NaF). L-arginine (2% w/v.) was incorporated in these varnishes to estimate F release at 1 h, 4 h, 6 h, 24 h, 3 days, and 7 days using an F-ion selective electrode. The media pH of eluded varnishes was estimated and primary inorganic F extraction was performed. The main effects pH, F release, and computed integrated mean/cumulative F release for experimental groups were significantly higher than the controls (p<0.01). The primary extracted F concentrations for the Arg-containing groups were significantly lower than the control groups (p<0.001) demonstrating a chemical interplay with Arg incorporation. To conclude, irrespective of the inorganic F content, incorporating Arg in F-containing varnishes increases their F release potential.
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Affiliation(s)
- Nouf Ali Alblooshi
- Paediatric Dentistry, Department of Clinical Sciences, College of Dentistry, Ajman University
| | | | - Cynthia Yiu
- Paediatric Dentistry, Faculty of Dentistry, University of Hong Kong
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Yip K, Abdalla MM, Bijle MN, Yiu C. Effect of arginine-fluoride varnish on preventing enamel erosion by paediatric liquid medicaments. BMC Oral Health 2023; 23:892. [PMID: 37985984 PMCID: PMC10662501 DOI: 10.1186/s12903-023-03621-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The study objective was to examine the effect of arginine-sodium fluoride (Arg-NaF) varnish on preventing enamel erosion by acidic paediatric liquid medicaments (PLM). METHODS The treatment groups were: 1) 2% Arg-NaF; 2) 4% Arg-NaF; 3) 8% Arg-NaF; 4) NaF; 5) MI (CPP-ACFP) varnishes; and 6) no varnish. The pH of PLM (paracetamol and chlorpheniramine) was measured at baseline and after immersing the Perspex® blocks coated with varnishes at 0 min, 30 min, 1 h, and 4 h. Seventy-two enamel specimens (n = 72) were randomly divided into 2 groups by PLM and further by treatment groups. Then, the specimens were pre-treated with varnishes and subjected to erosive cycles (5 min, 2×/day for 4 days) by PLM. After each erosive challenge, the specimens were stored in artificial saliva. At baseline and after 4 days, the specimens were assessed for surface roughness (Ra) using 2D-surface profilometric analysis (SPA) and atomic force microscopy (AFM). Additionally, the Ca/P ratio was determined using scanning electron microscopy with energy-dispersive X-ray spectroscopy. Paired samples dependent t-test, 1-way ANOVA and 2-way ANOVA with Bonferroni post-hoc tests were used to analyse data with the level of significance set at p < 0.05. RESULTS The pH of PLM with 8% Arg-NaF was significantly higher than the other groups at 30 min and 4 h (p < 0.05). With paracetamol, no significant difference was observed between the baseline and post-erosive cycle measured enamel Ra (by SPA/AFM) and Ca/P ratio for all treatment groups (p > 0.05). The Ra determined by AFM, at the post-erosive cycle with chlorpheniramine, when treated with 4 and 8% Arg-NaF was significantly lower than the other groups (p < 0.05); except CPP-ACFP (p > 0.05). With the chlorpheniramine post-erosive cycle, the Ca/P ratio for 4, 8% Arg-NaF and CPP-ACFP treated specimens was significantly higher than the baseline Ca/P (p < 0.05). CONCLUSION The 4%/8% Arg-NaF and MI varnish® application exhibit an enhanced preventive effect against low pH (pH < 3.0) PLM-mediated enamel erosive challenges compared to 5% NaF varnish.
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Affiliation(s)
- Kimberley Yip
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Island, Hong Kong
| | - Mohamed Mahmoud Abdalla
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Island, Hong Kong
- Dental Biomaterials, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohammed Nadeem Bijle
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Island, Hong Kong
| | - Cynthia Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Island, Hong Kong.
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Bijle MN, Abdalla MM, Hung IFN, Yiu CKY. The effect of synbiotic-fluoride therapy on multi-species biofilm. J Dent 2023; 133:104523. [PMID: 37080530 DOI: 10.1016/j.jdent.2023.104523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVES The study objective was to examine the effect of synbiotic-fluoride (SF) therapy within a multi-species cariogenic biofilm model system comprising of S. mutans, S. sanguinis, and S. gordonii. METHODS The SF therapy was prepared using 2% L-arginine (Arg), 0.2% NaF and probiotic L. rhamnosus GG (LRG). The 8 treatment groups were: Group 1: No treatment, Group 2: 2% Arg, Group 3: 0.2% NaF, Group 4: LRG, Group 5: 2% Arg+0.2% NaF, Group 6: 2% Arg+LRG, Group 7: 0.2% NaF+LRG, and Group 8: SF therapy (2% Arg+0.2% NaF +LRG). Multi-species biofilm model over 96 h comprising Streptococcus mutans, Streptococcus sanguinis, and Streptococcus gordonii was utilized. The biofilms received cariogenic challenge and SF therapy 2 × /day. The extracellular matrix components were analyzed for carbohydrates, proteins, and extra-cellular DNA (eDNA). The live/dead cells were imaged and quantified using confocal microscopy. The viable/dead bacterial concentrations were estimated using propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR). The gene expressions for gtfB, sagP, arcA, argG, and argH were measured using real-time reverse transcriptase qPCR. RESULTS Carbohydrates and protein content with SF therapy were higher than non-LRG containing groups, while eDNA content was lower than other groups (p<0.05). Live bacterial proportions determined using confocal imaging with SF therapy were the lowest (p<0.05). The 2% Arg+LRG and SF therapy showed higher viable L. rhamnosus GG than 0.2% NaF+LRG (p<0.05). The dead S. mutans with SF therapy were higher than the other groups (p<0.05) with no difference from 2% Arg+0.2% NaF and 2% Arg+LRG (p>0.05). The SF therapy significantly downregulates gtfB and upregulates sagP, arcA, argG, argH gene expression (p<0.05). CONCLUSION Synbiotic-fluoride therapy effectuates multi-fold changes in the multi-species biofilm matrix and cellular components leading to superior ecological homeostasis than its individual contents, prebiotics (arginine), probiotic (L. rhamnosus GG), and fluorides (NaF). CLINICAL SIGNIFICANCE The ecological-based synbiotic-fluoride caries-preventive therapy aids in maintaining biofilm homeostasis to preempt/restore dysbiosis thereby sustaining dynamic-diverse health-associated microbial stability significant as a preventive regimen for high caries-risk patients.
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Affiliation(s)
- Mohammed Nadeem Bijle
- Assistant Professor in Paediatric Dentistry, Department of Clinical Sciences, College of Dentistry, Ajman University, United Arab Emirates; Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates.
| | - Mohamed Mahmoud Abdalla
- Postdoctoral Fellow, Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong; Associate Professor, Dental Biomaterials, Faculty of Dental Medicine Al-Azhar University, Cairo, Egypt.
| | - Ivan Fan Ngai Hung
- Ru Chien and Helen Lieh Professor in Health Sciences Pedagogy, Clinical Professor, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Cynthia Kar Yung Yiu
- Clinical Professor in Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Lin X, Wang Y, Ma Z, Xie M, Liu Z, Cheng J, Tian Y, Shi H. Correlation between caries activity and salivary microbiota in preschool children. Front Cell Infect Microbiol 2023; 13:1141474. [PMID: 37113131 PMCID: PMC10126836 DOI: 10.3389/fcimb.2023.1141474] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/17/2023] [Indexed: 04/29/2023] Open
Abstract
Early childhood caries (ECC) is the most common chronic infectious oral disease in preschool children worldwide. It is closely related to the caries activity (CA) of children. However, the distribution characteristics of oral saliva microbiomes in children with different CA are largely underexplored. The aim of this study was to investigate the microbial community in saliva of preschool children with different CA and caries status, and to analyze the difference of microbial community in saliva of children with different CA and its correlation with ECC. Subjects were divided into 3 groups based on the Cariostat caries activity test: Group H, high CA (n=30); Group M, medium CA (n = 30); Group L, low CA (n=30). Questionnaire survey was used to explore the related influencing factors of CA. According to the caries status (on the basis of decayed mising filled teeth), these subjects were divided into caries-free group (dmft=0, n=19), caries-low group (0 < dmft ≤ 4, n=27) and caries-high group (dmft > 4, n=44). Microbial profiles of oral saliva were analyzed using 16S rRNA gene sequencing. There were significant differences in the microbial structure (P < 0.05). Scardovia and Selenomonas were the biomarkers of both H group and high caries group. The genus Abiotrophia and Lautropia were the biomarkers of both the L group and the low caries group, while the Lactobacillus and Arthrospira spp. were significantly enriched in the M group. The area under the ROC curve of the combined application of dmft score, age, frequency of sugary beverage intake, and the genus Scardovia, Selenomonas, and Campylobacter in screening children with high CA was 0.842. Moreover, function prediction using the MetaCyc database showed that there were significant differences in 11 metabolic pathways of salivary microbiota among different CA groups. Certain bacteria genera in saliva such as Scardovia and Selenomonas may be helpful in screening children with high CA.
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Affiliation(s)
- Xiuyan Lin
- Department of Pediatric Dentistry, Hospital of Stomatology and Hebei Provincial Key Laboratory of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Yuan Wang
- Department of Stomatology, Zhao County Maternal and Child Health Hospital, Shijiazhuang, China
| | - Zhe Ma
- Department of Preventive Dentistry, Hospital of Stomatology and Hebei Provincial Key Laboratory of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Meng Xie
- Department of Pediatric Dentistry, Hospital of Stomatology and Hebei Provincial Key Laboratory of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Zhuo Liu
- Department of Stomatology, Zhao County Maternal and Child Health Hospital, Shijiazhuang, China
| | - Jinghui Cheng
- Department of Stomatology, Zhao County Maternal and Child Health Hospital, Shijiazhuang, China
| | - Yuzhao Tian
- Department of Stomatology, Zhao County Maternal and Child Health Hospital, Shijiazhuang, China
| | - Hong Shi
- Department of Pediatric Dentistry, Hospital of Stomatology and Hebei Provincial Key Laboratory of Stomatology, Hebei Medical University, Shijiazhuang, China
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Maher YA, Rajeh MT, Hamooda FA, Zerain GO, Habis RM, Sulaimani RH, Albar ST, H Ali FM, Abdelaleem NA. Evaluation of the clinical impact and In Vitro antibacterial activities of two bioactive restoratives against S. mutans ATCC 25175 in class II carious restorations. Niger J Clin Pract 2023; 26:404-411. [PMID: 37203103 DOI: 10.4103/njcp.njcp_406_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background Streptococcus mutans is a Gram-positive opportunistic bacterial pathogen and that causes dental caries and then restorative treatment remains the best clinical practice approach to repair and prevent dental caries. Aims This study compared the antimicrobial performance of resin modified glass ionomer cement (RM-GIC) and ACTIVA restoratives by evaluating the S. mutans count, pH levels, and plaque index (PI) scores before and on the 7th day of restoration, and then determined the antimicrobial activities against S. mutans ATCC 25175 in both restoratives in vitro. Materials and Methods Seventy-eight eligible Saudi female participants, with class II carious lesions, were randomly distributed into RM-GIC and ACTIVA restorative groups. We evaluated the S. mutans count by the serial dilution technique and salivary pH by using a portable pH meter. The PI scores were determined by Silness-Löe method and the antibacterial activity by the agar well diffusion method. Statistical analysis of normality distribution was performed with the Kolmogorov-Smirnov and the difference between groups was an analysis by paired t-test. In addition, the independent sample was compared with the independent samples t-test. Results Both groups reduced the S. mutans count, pH acidity, and PI scores, and this reduction was statistically significant on the 7th day of restoration (P < 0.05), preference for ACTIVA. The in vitro antibacterial activity against S. mutans ATCC 25175 showed a non-significant difference between both bioactive restorative materials (P < 0.05). Conclusion The novel application of ACTIVA restorative material is a promising option for patients at risk of caries.
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Affiliation(s)
- Y A Maher
- Department of Basic Oral Sciences, College of Dentistry - Umm Al-Qura University, Makkah, Saudi Arabia; Department of Microbiology, Faculty of Science, Al-Azhar University, Cairo, Egypt
| | - M T Rajeh
- Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia
| | - F A Hamooda
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - G O Zerain
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - R M Habis
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - R H Sulaimani
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - S T Albar
- Dental Intern, Collage of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - F M H Ali
- Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - N A Abdelaleem
- Department of Conservative and Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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12
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Bijle MN, Abdalla MM, Chu CH, Yiu CKY. Synbiotic-fluoride synergism on enamel remineralization, cytotoxicity and genotoxicity. J Dent 2023; 128:104356. [PMID: 36370897 DOI: 10.1016/j.jdent.2022.104356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE(S) The objectives of the present study were to examine the - a) enamel remineralization potential of synbiotic-fluoride (SF) therapy using a multi-species bacterial pH-cycling model; and b) cytotoxic and genotoxic effects of SF therapy extracts. MATERIALS AND METHODS The SF therapy group comprised of 2% arginine (Arg), 0.2% NaF, and a probiotic Lactobacillus rhamnosus GG (LRG). The intervention groups studied were: 1) No treatment; 2) 2% Arg; 3) 0.2% NaF; 4) LRG; 5) 2% Arg+0.2% NaF; 6) 2% Arg+LRG; 7) 0.2% NaF+LRG; and 8) 2% Arg+0.2% NaF+LRG (SF therapy). The enamel remineralization potential of SF therapy was investigated under cariogenic biofilm challenge; while the cytotoxicity and genotoxicity of SF therapy extracts were examined on HGF-1 and Chinese hamster fibroblast V79, respectively. To determine the remineralization effect, the specimens were subjected to mineral density (MD) assessment using micro-CT, Ca/P molar ratio with SEM-EDX, and enamel fluoride uptake (EFU) estimates. The HGF-1 proliferation assessment was quantified using MTT/CCK-8 assays with qualitative analysis by nuclei staining Hoechst-based fluorescence imaging. The genotoxicity was determined by micronuclei formation test. RESULTS Mineral gain and %remineralization derived from MD assessment for the SF therapy were significantly higher than the other groups (p<0.05). The %ΔCa/P for the SF and 2% Arg+0.2% NaF were significantly higher than the other groups (p<0.05). The SF and 2% Arg+0.2% NaF groups had the highest EFU compared to the other groups (p<0.05). No significant difference in the %viable HGF-1 cells were observed between the treatment interventions and no treatment group (p>0.05). Compared to the EMS-positive control, the micronuclei formation for all the intervention groups was significantly lower (p<0.05), with no significant difference among the treatment groups (p>0.05). CONCLUSION The SF therapy enhanced enamel remineralization with no biocompatibility concerns. CLINICAL SIGNIFICANCE With the enhanced enamel remineralization potential discerned in the present study, the SF therapy can be used as a promising caries-preventive agent targeted for high caries-risk individuals.
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Affiliation(s)
- Mohammed Nadeem Bijle
- Department of Clinical Sciences, College of Dentistry, Ajman University, United Arab Emirates; Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates.
| | - Mohamed Mahmoud Abdalla
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong; Dental Biomaterials, Faculty of Dental Medicine Al-Azhar University, Cairo, Egypt.
| | - Chun Hung Chu
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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13
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López-Ruiz M, Navas F, Fernández-García P, Martínez-Erro S, Fuentes MV, Giráldez I, Ceballos L, Ferrer-Luque CM, Ruiz-Linares M, Morales V, Sanz R, García-Muñoz RA. L-arginine-containing mesoporous silica nanoparticles embedded in dental adhesive (Arg@MSN@DAdh) for targeting cariogenic bacteria. J Nanobiotechnology 2022; 20:502. [PMID: 36457046 PMCID: PMC9714087 DOI: 10.1186/s12951-022-01714-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Dental caries is the major biofilm-mediated oral disease in the world. The main treatment to restore caries lesions consists of the use of adhesive resin composites due to their good properties. However, the progressive degradation of the adhesive in the medium term makes possible the proliferation of cariogenic bacteria allowing secondary caries to emerge. In this study, a dental adhesive incorporating a drug delivery system based on L-arginine-containing mesoporous silica nanoparticles (MSNs) was used to release this essential amino acid as a source of basicity to neutralize the harmful acidic conditions that mediate the development of dental secondary caries. The in vitro and bacterial culture experiments proved that L-arginine was released in a sustained way from MSNs and diffused out from the dental adhesive, effectively contributing to the reduction of the bacterial strains Streptococcus mutans and Lactobacillus casei. Furthermore, the mechanical and bonding properties of the dental adhesive did not change significantly after the incorporation of L-arginine-containing MSNs. These results are yielding glimmers of promise for the cost-effective prevention of secondary caries.
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Affiliation(s)
- Marta López-Ruiz
- grid.28479.300000 0001 2206 5938Faculty of Health Sciences, IDIBO Research Group, Rey Juan Carlos University, Madrid, Spain
| | - Francisco Navas
- grid.28479.300000 0001 2206 5938Department of Chemical and Environmental Technology, Rey Juan Carlos University, C/ Tulipán S/N Móstoles, 28933 Madrid, Spain
| | - Paloma Fernández-García
- grid.28479.300000 0001 2206 5938Department of Chemical and Environmental Technology, Rey Juan Carlos University, C/ Tulipán S/N Móstoles, 28933 Madrid, Spain
| | - Samuel Martínez-Erro
- grid.28479.300000 0001 2206 5938Department of Chemical and Environmental Technology, Rey Juan Carlos University, C/ Tulipán S/N Móstoles, 28933 Madrid, Spain
| | - Mª Victoria Fuentes
- grid.28479.300000 0001 2206 5938Faculty of Health Sciences, IDIBO Research Group, Rey Juan Carlos University, Madrid, Spain
| | - Isabel Giráldez
- grid.28479.300000 0001 2206 5938Faculty of Health Sciences, IDIBO Research Group, Rey Juan Carlos University, Madrid, Spain
| | - Laura Ceballos
- grid.28479.300000 0001 2206 5938Faculty of Health Sciences, IDIBO Research Group, Rey Juan Carlos University, Madrid, Spain
| | - Carmen Mª Ferrer-Luque
- grid.4489.10000000121678994Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N, 18071 Granada, Spain
| | - Matilde Ruiz-Linares
- grid.4489.10000000121678994Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N, 18071 Granada, Spain
| | - Victoria Morales
- grid.28479.300000 0001 2206 5938Department of Chemical and Environmental Technology, Rey Juan Carlos University, C/ Tulipán S/N Móstoles, 28933 Madrid, Spain
| | - Raúl Sanz
- grid.28479.300000 0001 2206 5938Department of Chemical and Environmental Technology, Rey Juan Carlos University, C/ Tulipán S/N Móstoles, 28933 Madrid, Spain
| | - Rafael A. García-Muñoz
- grid.28479.300000 0001 2206 5938Department of Chemical and Environmental Technology, Rey Juan Carlos University, C/ Tulipán S/N Móstoles, 28933 Madrid, Spain
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Sangsuwan P, Chotigeat W, Tannukit S, Kedjarune-Leggat U. Long-Term Effect of Modified Glass Ionomer Cement with Mimicked Biological Property of Recombinant Translationally Controlled Protein. Polymers (Basel) 2022; 14:polym14163341. [PMID: 36015596 PMCID: PMC9412370 DOI: 10.3390/polym14163341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
This study modified glass ionomer cement (GIC) by adding mimicked biological molecules to reduce cell death. GIC was modified to BIOGIC by adding chitosan and bovine serum albumin for enhancing protein release. The BIOGIC was supplemented with tricalcium phosphate (TCP) and recombinant translationally controlled tumor protein (TCTP) to improve its biological properties. Four groups of materials, GIC, BIOGIC, BIOGIC+TCP, and BIOGIC + TCP + TCTP, were examined by XRD and SEM-EDX. TCTP released from the specimens was determined by an ELISA method. Human dental pulp stem cells (hDPSCs) were harvested and analyzed by MTT assay, apoptosis, gene expression, and cell differentiation. All groups had the same crystallization characteristic peaks of La2O3. The elemental compositions composed of La, Si, and Al are the main inorganic components. The results show that BIOGIC + TCP + TCTP presented significantly higher percentages of cell viability than other groups on day 1 to day 23 (p < 0.05), but were not different after day 24 to day 41 and had reduced cell apoptosis including BAX, TPT1, BCL-2, and Caspase-3. The BIOGIC + TCP + TCTP demonstrated higher odontoblast mineralization and differentiation markers including ALP activity, DSPP, DMP-1, ALP, BMP-2, and OPN. It enhanced cell proliferation and differentiation as well as mineralization with down-regulation of genes related to apoptosis compared with other groups.
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Affiliation(s)
- Prawichaya Sangsuwan
- Molecular Biology and Bioinformatics Program, Biological Science Division, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
| | - Wilaiwan Chotigeat
- Molecular Biology and Bioinformatics Program, Biological Science Division, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
| | - Sissada Tannukit
- Department of Oral Biology and Occlusion, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
- Cell Biology and Biomaterials Research Unit, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
| | - Ureporn Kedjarune-Leggat
- Department of Oral Biology and Occlusion, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
- Cell Biology and Biomaterials Research Unit, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
- Correspondence:
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15
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Pan T, Liu FS, Lin H, Zhou Y. Anti-biofilm studies of synthetic imidazolium salts on dental biofilm in vitro. J Oral Microbiol 2022; 14:2075309. [PMID: 35600163 PMCID: PMC9116249 DOI: 10.1080/20002297.2022.2075309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Biofilm formation under cariogenic conditions contributes to dental caries development, in which Streptococcus mutans (S. mutans) is regarded as the major cariogenic bacteria. Here, we synthesized a series of imidazolium salts. Their properties of antimicrobial and anti-biofilm were investigated. Methods The microdilution method crystal violet staining, and cell counting Kit-8 assay were used to screen imidazolium salts. Then, the bacterial composition in multi-species biofilm composed of S. mutans, Actinomyces naeslundii, and Streptococcus gordonii was quantified by quantitative PCR. The exopolysaccharide and morphology of the structure of multi-species biofilm were further observed by confocal laser scanning microscopy and scanning electron microscope, respectively. Results Imidazolium salts exhibited highly antimicrobial activity against oral pathogens, especially for S. mutans . Compounds with ortho-diisopropyl and para-methoxyl on N-moieties as well as bearing ancenaphthyl skeleton (C5) showed the lowest cytotoxicity and most efficient anti-biofilm activity. C5 inhibited approximately 50% of multi-species biofilm at 0.98 μg/mL. Notably, C5 resulted in 98.97% live S. mutans and 77.65% A. naeslundii decreased. Furthermore, the exopolysaccharide was reduced by 88%, along with a sparse and scattered microstructure. Conclusion The imidazolium salts present low cytotoxicity and remarkable antimicrobial activity against S. mutans in multi-species biofilm, suggesting that they may have a great potential in anti-biofilm clinical applications.
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Affiliation(s)
- Ting Pan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-sen University, Guangzhou, China
| | - Feng-Shou Liu
- School of Chemistry and Chemical Engineering, Guangdong Pharmaceutical University, Zhongshan, China
| | - Huancai Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-sen University, Guangzhou, China
| | - Yan Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-sen University, Guangzhou, China
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16
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Biofilm modulatory response of arginine-fluoride varnish on multi-species biofilm. J Dent 2022; 122:104096. [DOI: 10.1016/j.jdent.2022.104096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 11/20/2022] Open
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Bijle MN, Pichika MR, Mak KK, Parolia A, Babar MG, Yiu C, Daood U. Concentration-Dependent Multi-Potentiality of L-Arginine: Antimicrobial Effect, Hydroxyapatite Stability, and MMPs Inhibition. Molecules 2021; 26:6605. [PMID: 34771014 PMCID: PMC8586951 DOI: 10.3390/molecules26216605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/17/2021] [Accepted: 10/17/2021] [Indexed: 11/16/2022] Open
Abstract
This study's objective was to examine L-arginine (L-arg) supplementation's effect on mono-species biofilm (Streptococcus mutans/Streptococcus sanguinis) growth and underlying enamel substrates. The experimental groups were 1%, 2%, and 4% arg, and 0.9% NaCl was used as the vehicle control. Sterilised enamel blocks were subjected to 7-day treatment with test solutions and S. mutans/S. sanguinis inoculum in BHI. Post-treatment, the treated biofilms stained for live/dead bacterial cells were analysed using confocal microscopy. The enamel specimens were analysed using X-ray diffraction crystallography (XRD), Raman spectroscopy (RS), and transmission electron microscopy (TEM). The molecular interactions between arg and MMP-2/MMP-9 were determined by computational molecular docking and MMP assays. With increasing arg concentrations, bacterial survival significantly decreased (p < 0.05). The XRD peak intensity with 1%/2% arg was significantly higher than with 4% arg and the control (p < 0.05). The bands associated with the mineral phase by RS were significantly accentuated in the 1%/2% arg specimens compared to in other groups (p < 0.05). The TEM analysis revealed that 4% arg exhibited an ill-defined shape of enamel crystals. Docking of arg molecules to MMPs appears feasible, with arg inhibiting MMP-2/MMP-9 (p < 0.05). L-arginine supplementation has an antimicrobial effect on mono-species biofilm. L-arginine treatment at lower (1%/2%) concentrations exhibits enamel hydroxyapatite stability, while the molecule has the potential to inhibit MMP-2/MMP-9.
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Affiliation(s)
| | - Mallikarjuna Rao Pichika
- Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia; (M.R.P.); (K.-K.M.)
| | - Kit-Kay Mak
- Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia; (M.R.P.); (K.-K.M.)
| | - Abhishek Parolia
- Clinical Dentistry Division, School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia;
| | - Muneer Gohar Babar
- Children and Community Oral Health, School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia;
| | - Cynthia Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong;
| | - Umer Daood
- Clinical Dentistry Division, School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia;
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