A review of chitosan's effect on oral biofilms: Perspectives from the tube to the mouth

The potential of suspended chitosan nanoparticles as a surgical irrigation fluid

In this study, we sought to synthesize chitosan nanoparticles (CS-NPs) and characterize their morphology, efficacy in inhibiting bacterial attachment, and efficacy in eradicating bacteria established on implantable hardware. CS-NPs possess desirable properties, including antibacterial properties in biofilm-mediated infections. CS-NPs were produced using ionic gelation and characterized via scanning electron microscope imaging. Staphylococcus aureus was incubated with CS-NPs at various concentrations and compared to a 1% povidone-iodine with 1% H2 O2 control in 24-well plates. Stainless steel bone screws were placed in six-well plates and inoculated with S. aureus. After 24 h, the screws were transferred to one of three solutions (saline, 40 mg/mL CS-NP, or 1% povidone-iodine with 1% H2 O2 ). Four screws from each group were vortexed in saline and plated. The remaining screw from each group was prepped and imaged to map the location of persistent bacteria. Synthesized CS-NPs had a mean diameter of 0.39 ± 0.13 μm and circularity of 0.87 ± 0.05. The percent inhibition of bacterial attachment was 73% at 20 mg/mL, 73% at 30 mg/mL, 75% at 40 mg/mL, 79% at 50 mg/mL, and 78% at 60 mg/mL. When compared to saline, the 40 mg/mL CS-NP solution reduced bacteria on the screws by 76%. No bacteria were retrieved from the 1% povidone-iodine with 1% H2 O2 group. This study demonstrated that CS-NP solution effectively inhibited S. aureus bacterial attachment and was more effective than saline in eradicating bacteria from orthopedic hardware, suggesting that CS-NPs have the potential for prevention and treatment of musculoskeletal infections as a component of an intraoperative surgical irrigation solution.

Biomolecules based hydrogels and their potential biomedical applications: A comprehensive review

The need for biocompatible drug carriers has been significantly increased from the past few years. Researchers show great interest in the development of more versatile and sophisticated biomaterials based drug carriers. Hydrogels are beneficial drug carriers and easily release the controlled amount of drug at target site due to its tunable structure. The hydrogels made-up of potent biological macromolecules including collagen, gelatin, fibrin, elastin, fibroin, chitosan, starch, alginate, agarose and carrageenan have been proven as versatile biomaterials. These are three-dimensional polymeric networks, synthesized by crosslinking of hydrophilic polymers. The biological macromolecules based hydrogels containing therapeutic substances are used in a wide range of biomedical applications including wound healing, tissue engineering, cosmetics and contact lenses. However, many aspects related to hydrogels such as the mechanism of cross-linking and molecular entanglement are not clear. So, there is a need to do more research and exploration toward the extensive and cost-effective use of hydrogels. The present review article elaborately discusses the biomolecules based hydrogels and their possible biomedical applications in different fields.

Design and Evaluation of Paeonol-Loaded Liposomes in Thermoreversible Gels for Atopic Dermatitis

Paeonol (PAE) is a hydrophobic drug. In this study, we encapsulated paeonol in a lipid bilayer of liposomes (PAE-L), which delayed drug release and increased drug solubility. When PAE-L was dispersed in gels (PAE-L-G) based on a poloxamer matrix material for local transdermal delivery, we observed amphiphilicity, reversible thermal responsiveness, and micellar self-assembly behavior. These gels can be used for atopic dermatitis (AD), an inflammatory skin disease, to change the surface temperature of the skin. In this study, we prepared PAE-L-G at an appropriate temperature for the treatment of AD. We then assessed the gel’s relevant physicochemical properties, in vitro cumulative drug release, and antioxidant properties. We found that PAE-loaded liposomes could be designed to increase the drug effect of thermoreversible gels. At 32 °C, PAE-L-G could change from solution state to gelatinous state at 31.70 ± 0.42 s, while the viscosity was 136.98 ± 0.78 MPa.S and the free radical scavenging rates on DPPH and H2O2 were 92.24 ± 5.57% and 92.12 ± 2.71%, respectively. Drug release across the extracorporeal dialysis membrane reached 41.76 ± 3.78%. In AD-like mice, PAE-L-G could also relieve skin damage by the 12th day. In summary, PAE-L-G could play an antioxidant role and relieve inflammation caused by oxidative stress in AD.

Potential Effect of Giant Freshwater Prawn Shell Nano Chitosan in Inhibiting the Development of Streptococcus mutans and Streptococcus sanguinis Biofilm In Vitro

An oral biofilm comprises a variety of bacteria including Streptococcus mutans and Streptococcus sanguinis that cause human infections, such as caries and periodontitis. Thus, biofilm management plays an important part in the prevention and treatment of oral diseases. Nano chitosan is a bioactive material that has antimicrobial activities. This in vitro study aimed to evaluate the effect of nano chitosan synthesized from giant freshwater prawn shells (PSNC) on S. mutans and S. sanguinis biofilm development. PSNC was prepared from the extracted chitosan of giant freshwater prawn (Macrobrachium rosenbergii) shells using the ionic gelation method. The effect of PSNC on S. mutans ATCC 25175 and S. sanguinis ATCC10556 biofilm formation was evaluated using the crystal violet assay. Both bacteria were inoculated in the presence of various concentrations (5, 2.5, and 1.25 mg/ml) of PSNC for 24 h and 48 h. Confocal laser scanning microscopy (CLSM) and scanning electron microscopy were performed to visualize and study the biofilm architectural features. The biofilms were stained with the BacLight Bacterial Viability Kit prior to CLSM observation to monitor the viability of the biofilm. The results showed that PSNC exposure for 24 h and 48 h inhibited the formation of S. mutans and S. sanguinis biofilms. The biofilm formation inhibition percentage increased with an increase in the PSNC concentration (p < 0.05). The highest inhibitory activity was shown at 5 mg/ml PSNC (p < 0.05). Those findings were confirmed by the subsequent findings using the CLSM and SEM analyses. The biofilm architecture was strongly disrupted upon treatment with PSNC. After exposure to 5 mg/ml PSNC, the number of bacteria significantly decreased. The remaining bacteria were seen as individual cells, showing damaged cells. In conclusion, PSNC inhibits the development of S. mutans and S. sanguinis biofilm in vitro, indicating the potential of PSNC in clinical application for oral bacterial infection, prevention, and treatment.

Synthesis of Submicrometric Chitosan Particles Loaded with Calcium Phosphate for Biomedical Applications

Chitosan particles loaded with dibasic calcium phosphate anhydrous (DCPA) is a promising strategy for combining antimicrobial and osteoconduction properties in regenerative medicine. However, mostly micrometer-sized particles have been reported in the literature, limiting their use and reducing their effect in the biomedical field. We have recently overcome this limitation by developing submicrometer-sized particles with electrospray technique. The objective of this study was to understand how the process parameters control the size and properties of submicrometer chitosan particles loaded with DCPA. Solutions of 10 mg/mL chitosan and 2.5 mg/mL DCPA in a 90% acetic acid were electrosprayed under three distinct flow rate conditions: 0.2, 0.5, and 1.0 mL/h. The particles were crosslinked in a glutaraldehyde atmosphere and characterized in terms of their morphology, inorganic content, zeta potential, and minimum inhibitory concentration (MIC) against S. mutans. All conditions showed particles with two similar morphologies: one small-sized with a spherical shape and another larger-sized with a bi-concave shape. All generated a broad particle size distribution, with a similar mean size of ~ 235 nm. The addition of DCPA decreased the zeta potential for all the samples, but it was above 30 mV, indicating a low aggregation potential. The lower flow rate showed the worst efficacy for DCPA incorporation. Antimicrobial activity was greater in chitosan/DCPA particles with flow rate of 0.5 mL/h. It can be concluded that the flow rate of 0.5 mL/h presents the best compromise solution in terms of morphology, zeta potential, MIC, and inorganic content.

Natural-Fiber-Reinforced Chitosan, Chitosan Blends and Their Nanocomposites for Various Advanced Applications

There has been much effort to provide eco-friendly and biodegradable materials for the next generation of composite products owing to global environmental concerns and increased awareness of renewable green resources. This review article uniquely highlights the use of green composites from natural fiber, particularly with regard to the development and characterization of chitosan, natural-fiber-reinforced chitosan biopolymer, chitosan blends, and chitosan nanocomposites. Natural fiber composites have a number of advantages such as durability, low cost, low weight, high specific strength, non-abrasiveness, equitably good mechanical properties, environmental friendliness, and biodegradability. Findings revealed that chitosan is a natural fiber that falls to the animal fiber category. As it has a biomaterial form, chitosan can be presented as hydrogels, sponges, film, and porous membrane. There are different processing methods in the preparation of chitosan composites such as solution and solvent casting, dipping and spray coating, freeze casting and drying, layer-by-layer preparation, and extrusion. It was also reported that the developed chitosan-based composites possess high thermal stability, as well as good chemical and physical properties. In these regards, chitosan-based “green” composites have wide applicability and potential in the industry of biomedicine, cosmetology, papermaking, wastewater treatment, agriculture, and pharmaceuticals.

Biofilm formation following chitosan-based varnish or chlorhexidine-fluoride varnish application in patients undergoing fixed orthodontic treatment: a double blinded randomised controlled trial

Background

Orthodontic treatment poses an increased risk of plaque accumulation and demineralisation of enamel leading to white spot lesion around the brackets. This parallel arm trial aims to assess the degree of bacterial plaque formation adjacent to orthodontic brackets, following the application of a chitosan-based varnish or chlorhexidene-fluoride varnish.

Methods

A total of 200 teeth from 20 patients undergoing fixed orthodontic therapy were assessed and biofilm formation around the brackets were recorded using the Bonded Bracket Index (Plaque index) at baseline and weekly for 6 weeks. The bacterial count and plaque pH at corresponding weekly intervals were also recorded. Following bracket bonding, the patients were cluster randomised to receive chitosan-based varnish-CHS (UNO Gel Bioschell, Germiphene corp., Brantford, Canada) or chlorhexidine-fluoride varnish-CFV (Cervitec F, Ivoclar Vivadent, Schaan, Liechtenstein) every week on the representative teeth respectively. BBI proportions were compared between groups at all time intervals using Chi square test. Mean plaque bacterial count and plaque pH were compared using Mann Whitney U test and Tukey’s HSD test respectively.

Results

Baseline characteristics were similar between the groups: Mean age was CHS = 23 and CFV = 21; male to female ratio was CHS = 5/5, CFV = 7/3. At the end of 6 weeks, chitosan-based varnish performed equal to chlorhexidine-fluoride varnish (P > 0.05) with 98% and 95% of teeth with acceptable scores respectively. The plaque bacterial count significantly reduced at 6 weeks for both varnish compared to the baseline; The value for CHS was 0.43 ± 0.4 × 10⁴ and CFV was 0.77 ± 0.64 × 10⁴ CFU (P < 0.05), with no difference between both the varnishes. Both varnishes had no effect on the plaque pH that remained neutral.

Conclusion

This trial showed that both chitosan-based varnish and chlorhexidine-fluoride varnish reduced bacterial count, while the plaque pH remained neutral over a period of six weeks in patients undergoing fixed orthodontic therapy. The anti-plaque effects of the natural biopolymeric chitosan-based varnish was similar to that of chlorhexidine-fluoride varnish, a known chemotherapeutic agent.

Registration: This trial protocol was registered with https://www.ctri.nic.in (CTRI/2019/05/018896). (Date of registration 02/05/2019).

Protocol: The protocol was not published before trial commencement.

Current status and future of delivery systems for prevention and treatment of infections in the oral cavity

Oral health reflects the general health, and it is fundamental to well-being and quality of life. An infection in the oral cavity can be associated with serious complications in human health. Local therapy of these infections offers many advantages over systemic drug administration, targeting directly to the diseased area while minimizing systemic side effects. Specialized drug delivery systems into the oral cavity have to be designed in such a fashion that they resist to the aqueous environment that is constantly bathed in saliva and subject to mechanical forces. Additionally, a prolonged release of drug should also be provided, which would enhance the efficacy and also decrease the repeated dosing. This review is aimed to summarize the current most relevant findings related to local drug delivery of various drug groups for prevention and treatment of infections (viral, bacterial, fungal) and infection-related manifestations in the oral cavity. Current therapeutic challenges in regard to effective local drug delivery systems will be discussed, and the recent approaches to overcome these obstacles will be reviewed. Finally, future prospects will be overviewed to promote novel strategies that can be implemented in clinical management for prevention and treatment of oral infections.

Biopolymers for hydrogels in cosmetics: review

Hydrogels are cross-linked networks of macromolecular compounds characterized by high water absorption capacity. Such materials find a wide range of biomedical applications. Several polymeric hydrogels can also be used in cosmetics. Herein, the structure, properties and selected applications of hydrogels in cosmetics are discussed in general. Detailed examples from scientific literature are also shown. In this review paper, most common biopolymers used in cosmetics are presented in detail together with issues related to skin treatment and hair conditioning. Hydrogels based on collagen, chitosan, hyaluronic acid, and other polysaccharides have been characterized. New trends in the preparation of hydrogels based on biopolymer blends as well as bigels have been shown. Moreover, biopolymer hydrogels employment in encapsulation has been mentioned.

Application of biosurfactants and chitosan in toothpaste formulation

The aim of the present study was to formulate toothpastes containing biosurfactants and either fungal chitosan or sodium fluoride and evaluate the cytotoxicity, antimicrobial action and inhibition potential against biofilm formed by Streptococcus mutans. Chitosan was extracted from the biomass of the fungus Mucorales. We tested biosurfactants produced by Pseudomonas aeruginosa UCP 0992 (PB), Bacillus metylotrophicus UCP 1616 (BB) and Candida bombicola URM 3718 (CB). Fractional inhibitory concentration analysis was performed to determine the type of interaction between the compounds. Six toothpaste were prepared, the active ingredients of which were the biosurfactants, chitosan or sodium fluoride. The cytotoxicity tests were performed using the 3-[4,5-dimethyl-2-thiazolyl]-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay for the L929 (mouse fibroblast) and RAW 264.7 (mouse macrophage) cell lines. The toothpastes were tested with regard to pH, consistency and foaming capacity. The inhibition of biofilm was investigated by applying the toothpaste to biofilm formed in modified artificial saliva for 24 h at 37 °C in anaerobiosis. All substances had a minimum inhibitory concentration (MIC) for S. mutans. The combinations of CB and PB with chitosan had an additive effect against S. mutans, whereas BB combined with chitosan had an indifferent effect. The toothpastes were non-toxic. The formulations had pH around 9, spreading capacity between 8 and 17 mm and foaming capacity between 63 and 95%. All formulations inhibited the cellular viability of S. mutans in the biofilm, with similar results compared to the commercial toothpaste tested. The present results show that the formulations suggested are promising when compared to a commercial tooth paste.

A Proposal of Remedies for Oral Diseases Caused by Candida: A Mini Review

An opportunistic pathogen, Candida is not only related to oral problems such as oral candidiasis and denture stomatitis, but also to systemic diseases such as aspiration pneumonia and fungemia. The carriage rate of Candida species in the oral cavity of individuals wearing dentures and with removable orthodontic appliances, has increased. Moreover, it is one of the causal pathogens in refractory infected root canals because of its resistance to antifungal drugs in root canal therapy and poses a great challenge during the treatment of patients. This problem has led to the search for alternative strategies for the treatment and management of C. albicans infections. In this mini review, recent preventive strategies against Candida infection in the oral mucosa with natural product-derived antifungal molecules were discussed. Inhibitory strategies by introducing competitive naturally-derived antifungal peptide molecules with Candida adhesion molecules were specifically introduced. In addition, novel sterilization methods for Candida-infected root canals and tooth structures in the oral cavity were considered, with focused attention on the activities of reactive oxygen species. The possibility of application of these novel strategies in clinical treatments and daily life was also proposed.

Linalool, citral, eugenol and thymol: control of planktonic and sessile cells of Shigella flexneri

The antimicrobial activity of linalool, citral, eugenol and thymol was determined in growth studies of both planktonic (PC) and biofilm cells (BC) Shigella flexneri. These components were evaluated either in isolation or in combinations using a sequential experimental strategy with Plackett & Burman and central composite rotational designs totaling 47 treatments. The minimum inhibitory concentration for PC was 0.125% (v v⁻¹) for linalool and 0.5% (v v⁻¹) for citral, eugenol and thymol. The biofilm minimum bactericidal concentration was 3 and 1% (v v⁻¹) for linalool and citral, respectively, and 2% (v v⁻¹) for eugenol and thymol. In the mixtures, the minimum concentrations in the efficient assays for PC growth inhibition were 0.0003, 0.0443 and 0.0443% (v v⁻¹), for linalool, citral and thymol, respectively. In the BC, only two assays with concentrations of 0.0558, 0.0558 and 0.319% (v v⁻¹) and 0.035, 0.035 and 0.3999% (v v⁻¹) for linalool, citral and thymol, respectively, inhibited Shigella growth. Synergism was observed among the components, where PC and BC growth inhibition occurred at lower concentrations than those noted individually. The bactericidal effect of the components in microplate was different from the observed in stain steel coupons. Therefore, the obtained model can describe and predict the PC count of S. flexneri in medium with the tested compounds and they could be an alternative for the use in microbiological control in food industry.

Cosmetics and Cosmeceutical Applications of Chitin, Chitosan and Their Derivatives

Marine resources are well recognized for their biologically active substances with great potential applications in the cosmeceutical industry. Among the different compounds with a marine origin, chitin and its deacetylated derivative—chitosan—are of great interest to the cosmeceutical industry due to their unique biological and technological properties. In this review, we explore the different functional roles of chitosan as a skin care and hair care ingredient, as an oral hygiene agent and as a carrier for active compounds, among others. The importance of the physico-chemical properties of the polymer in its use in cosmetics are particularly highlighted. Moreover, we analyse the market perspectives of this polymer and the presence in the market of chitosan-based products.