Analysis of glucosyltransferase gene expression of clinical isolates of Streptococcus mutans obtained from dental plaques in response to sub-lethal doses of photoactivated disinfection

Application of antimicrobial sonodynamic therapy as a potential treatment modality in dentistry: A literature review

The accumulation of dental plaque is a precursor to various dental infections, including lesions, inflammation around dental implants, and inflammation under dentures. Traditional cleaning methods involving physical removal and chemical agents often fall short of eliminating bacteria and their protective biofilms. These methods can also inadvertently lead to bacteria that resist drugs and upset the mouth's microbial harmony. To counter these issues, a new approach is needed that can target and clear away dental plaque, minimize biofilms and bacteria, and thus support sustained dental health. Enter antimicrobial sonodynamic therapy (aSDT), a supplementary treatment that uses gentle ultrasound waves to trigger a sonosensitizer compound, destroying bacterial cells. This process works by generating heat, mechanical pressure, initiating chemical reactions, and producing reactive oxygen species (ROS), offering a fresh tactic for managing dental plaque and biofilms. The study reviews how aSDT could serve as an innovative dental treatment option to enhance oral health.

Application of photosensitive dental materials as a novel antimicrobial option in dentistry: A literature review

The formation of dental plaque is well-known for its role in causing various oral infections, such as tooth decay, inflammation of the dental pulp, gum disease, and infections of the oral mucosa like peri-implantitis and denture stomatitis. These infections primarily affect the local area of the mouth, but if not treated, they can potentially lead to life-threatening conditions. Traditional methods of mechanical and chemical antimicrobial treatment have limitations in fully eliminating microorganisms and preventing the formation of biofilms. Additionally, these methods can contribute to the development of drug-resistant microorganisms and disrupt the natural balance of oral bacteria. Antimicrobial photodynamic therapy (aPDT) is a technique that utilizes low-power lasers with specific wavelengths in combination with a photosensitizing agent called photosensitizer to kill microorganisms. By inducing damage through reactive oxygen species (ROS), aPDT offers a new approach to addressing dental plaque and associated microbial biofilms, aiming to improve oral health outcomes. Recently, photosensitizers have been incorporated into dental materials to create photosensitive dental materials. This article aimed to review the use of photosensitive dental materials for aPDT as an innovative antimicrobial option in dentistry, with the goal of enhancing oral health.

Antimicrobial photodynamic therapy against oral biofilm: influencing factors, mechanisms, and combined actions with other strategies

Oral biofilms are a prominent cause of a wide variety of oral infectious diseases which are still considered as growing public health problems worldwide. Oral biofilms harbor specific virulence factors that would aggravate the infectious process and present resistance to some traditional therapies. Antimicrobial photodynamic therapy (aPDT) has been proposed as a potential approach to eliminate oral biofilms via in situ-generated reactive oxygen species. Although numerous types of research have investigated the effectiveness of aPDT, few review articles have listed the antimicrobial mechanisms of aPDT on oral biofilms and new methods to improve the efficiency of aPDT. The review aims to summarize the virulence factors of oral biofilms, the progress of aPDT in various oral biofilm elimination, the mechanism mediated by aPDT, and combinatorial approaches of aPDT with other traditional agents.

Rutin-gallium complex mediated antimicrobial photodynamic therapy: An in vitro studies against Streptococcus mutans biofilms

BACKGROUND

Discoloration of teeth following antimicrobial photodynamic therapy (aPDT) is a serious concern. Common photosensitizers are colored, and access to a photosensitizer that does not leave color on the teeth or is the same color as the enamel and dentin is highly demanded. The physicochemical characterization, anti-virulence, and antimicrobial effects of a novel rutin-gallium (III) (Rt-Ga) complex as novel photosensitizer are presented herein.

MATERIALS AND METHODS

Photophysical properties and cytotoxicity of the Rt-Ga complex were evaluated in comparison with the parental rutin. Intracellular reactive oxygen species (ROS) generation following Rt-Ga complex-mediated aPDT was measured using the fluorescent 2',7'-dichlorofluorescein diacetate (H2DCF-DA) method. The anti-biofilm effects of Rt-Ga complex-mediated aPDT on Streptococcus mutans were assessed using a colorimetric assay. The virulence‑associated gtfB gene expression was assessed following Rt-Ga complex-mediated aPDT by quantitative real‑time PCR.

RESULTS

The photophysical properties of the Rt-Ga complex revealed a significant blue-shift in absorption (60 nm shift) and increased extinction coefficient (4100 M -1 cm -1; at λmax = 450 nm). Average (± SEM) DCF fluorescence intensities in an arbitrary unit (A.U.) were 7.1 ± 0.9, 4.1 ± 0.5, and 1.7 ± 0.3 for 10.0 μM of Rt-Ga complex-mediated aPDT, 7.5 μM of Rt-Ga complex-mediated aPDT, and 10.0 μM of Rt-Ga complex alone, respectively. The corresponding DCF fluorescence intensities were 710% (P = 0.001), 410% (P = 0.001), and 170% (P = 0.02) of the untreated S. mutans as the control group (1.0 ± 0.1 A.U.), respectively. The novel Rt-Ga complex-mediated aPDT exhibited no toxicity against primary human gingival fibroblast cells, a dose dependent decrease in S. mutans biofilm cell survival and virulence were observed (91.4% and 11.7-fold, respectively).

CONCLUSION

The Rt-Ga complex-mediated anti-virulence and antimicrobial photodynamic effects were superior to the one caused by rutin alone making the Rt-Ga complex a more promising photosensitizer than the parent material.

Ex-vivo effects of propolis quantum dots-nisin-nanoquercetin-mediated photodynamic therapy on Streptococcus mutans biofilms and white spot lesions

BACKGROUND

White spot lesions (WSLs) remain one of the most critical adverse sequelae of fixed orthodontic treatment, despite materials and techniques advances in orthodontics. WSLs seem to be a multi-factorial interaction including increased microbial plaque due to intrabuccal appliances that limit the oral-cleansing mechanism and change in the oral microbiome during fixed appliance wear. The aim of this study was to investigate the synergistic effect of propolis quantum dots (PQD), nisin (Nis), and quercetin nanoparticles (nQCT)-mediated photodynamic therapy (PQD-Nis-nQCT-mediated aPDT) in the eradication of Streptococcus mutans biofilms and the remineralization of WSLs ex-vivo.

MATERIALS AND METHODS

The cytotoxicity of PQD-Nis-nQCT composite on human gingival fibroblasts was evaluated using neutral red. Intracellular reactive oxygen species (ROS) generation following PQD-Nis-nQCT-mediated aPDT was measured. Enamel slabs were prepared and demineralized using a demineralization solution containing S. mutans. Demineralized enamel slabs were divided into 9 groups (n = 10) and treated in the following groups: 1) Artificial saliva (negative control), 2) 2% neutral sodium fluoride gel (NSF; positive control or treatment control, 3) PQD, 4) Nis, 5) nQCT, 6) Nis-nQCT, 7) PQD-Nis-nQCT 8) Blue laser irradiation (light), 9) PQD-Nis-nQCT with irradiation (PQD-Nis-nQCT-mediated aPDT). Then, the surface changes, microhardness, and surface topography of the demineralized slabs were examined following each treatment using DIAGNOdent Pen reading, digital hardness tester, and SEM, respectively. After the determination of minimum biofilm eradication concentration (MBEC) of PQD, Nis, and nQCT by microtiter plate assay, the synergistic antimicrobial effects of PQD and Nis-nQCT were determined via evaluation of fractional biofilm eradication concentration (FBEC) index. The anti-biofilm effects of each treatment on S. mutans were assessed using a colorimetric assay. The virulence‑associated gtfB gene expression was assessed following PQD-Nis-nQCT-mediated aPDT by quantitative real‑time PCR.

RESULTS

PQD-Nis-nQCT at 2048 µg/mL had no significant cell cytotoxicity on human gingival fibroblasts compared to the control group (P > 0.05). A significantly increased (7.6 fold) in intracellular ROS was observed following PQD-Nis-nQCT-mediated aPDT (13.9 ± 1.41) when compared to the control (1.83 ± 0.13). Following each treatment, the microhardness of the demineralized enamel surface significantly increased except for the artificial saliva (negative) and blue laser irradiation groups. The highest change in microhardness improvement was detected in the PQD-Nis-nQCT-mediated aPDT group (P < 0.05). Also, DIAGNODent Pen reading revealed the highest significant improved change in the level of mineralization degree in the PQD-Nis-nQCT-mediated aPDT group. Nis and blue light irradiation groups, like the artificial saliva-treated demineralized enamel slabs (control group), did not lead to remineralization (P > 0.05). Also, the PQD-Nis-nQCT-mediated aPDT treatment results obtained from SEM revealed that remineralization of demineralized enamel slabs in that group has significantly improved compared to the others. Light-activated nQCT, PQD, Nis-nQCT, and PQD-Nis-nQCT composite significantly reduced pre-formed biofilms of S. mutans compared with unactivated forms of test materials. The relative expression level of the virulence gtfB gene was significantly decreased (7.53-fold) in the presence of PQD-Nis-nQCT-mediated aPDT (P < 0.05).

CONCLUSION

PQD-Nis-nQCT-mediated aPDT can be used for the eradication of S. mutans biofilms and remineralization of WSLs. The found in vitro efficacy should be tested further through clinical studies.

Effect of nanomicelle curcumin-based photodynamic therapy on the dynamics of white spot lesions and virulence of Streptococcus mutans in patients undergoing fixed orthodontic treatment: A randomized double-blind clinical trial

BACKGROUND/PURPOSE

The formation of white spot lesions (WSLs) around fixed orthodontic appliances is a major complication during treatment. The current double-blind, randomized clinical trial (RCT) study aims to investigate the varying effects of nanomicelle curcumin-based photodynamic therapy (NMCur-aPDT) on microbial count and virulence of Streptococcus mutans as well as the number and dynamics of WSLs.

MATERIALS AND METHODS

Double-blind prospective RCT, comprised of 48 patients with fixed orthodontic appliances, were recruited for the current study. The patients were divided into four groups according to the type of the treatment (NMCur, LED, NMCur-aPDT or VITIS® anti-caries mouthwash), using block randomization. Antimicrobial and anti-virulence activities of the treatments against isolated S. mutans were assessed via colony counting and quantitative real-time polymerase chain reaction (qRT-PCR), respectively. The visual inspection using the International Caries Detection and Assessment System (ICDAS II) score and laser fluorescence (LF) detection using a DIAGNOdent device were used for the detection and assessment of the dynamics of WSLs, respectively, on the labial surface in four areas (i.e., gingival, incisal, mesial, and distal) of the upper and lower anterior teeth at 30-, 60-, 90-, and 120-days follow-up after bonding of the lower and upper arches.

RESULTS

The antimicrobial properties of NMCur, VITIS®, and NMCur-aPDT were time-dependent so the highest reduction in S. mutans population was observed following NMCur-aPDT (99.98%) on day 120 of the study. The gtfB gene expression levels in S. mutans isolates from the NMCur-aPDT group on days 60, 90, and 120 decreased by 2.07-, 2.32-, and 3.01-fold more than in S. mutans isolates from the VITIS® group, respectively (all P < 0.05), while NMCur and LED treatments could not significantly reduce gtfB gene expression up to 120 days of follow-up (P > 0.05). In patients who were treated with LED, an increase in the mean number of WSLs per patient (mean increase, 1.8; P < 0.05) was found, while in NMCur-aPDT and VITIS® groups, not only no increases were observed, but the mean number of WSLs per patient decreased (mean reductions, 0.5 and 0.9, respectively; not significant). LED treatment caused significant increases (P < 0.05) in the mean LF values at 90-and 120-days of follow-up in comparison with the baseline (mean increases, 5.1 and 6.5, respectively) while, in NMCur-aPDT, VITIS®, and NMCur groups 11.8-, 7.1-, and 4.4-reductions in the mean LF values were observed, respectively (all, P < 0.05).

CONCLUSIONS

The antimicrobial and anti-virulence activities of NMCur-aPDT against S. mutans were higher than the other treatment groups. In patients who were treated with NMCur-aPDT, the mean number and LF values of WSLs per patient were significantly lower than the other groups in 90-and 120-days of follow-up.

Physico-mechanical properties, antimicrobial activities, and anti-biofilm potencies of orthodontic adhesive containing cerium oxide nanoparticles against Streptococcus mutans

Introduction: White spot lesions around orthodontic brackets may lead to the formation of dental caries during and following fixed orthodontic treatment.

Aim: This study aimed to evaluate the physico-mechanical properties and antimicrobial potencies of orthodontic adhesive doped with cerium oxide nanoparticles (CeO2-NPs) against Streptococcus mutans.

Materials and methods: After synthesis and conformation of CeO2-NPs by transmission electron microscope (TEM), shear bond strength (SBS) and adhesive remnant index (ARI) of modified orthodontic adhesive containing different concentrations of CeO2-NPs (0, 1, 2, 5, and 10 wt%) were measured. The antimicrobial effects of modified orthodontic adhesive were evaluated by disk agar diffusion method and biofilm formation inhibition assay.

Results: The pseudo-spherical shapes of CeO2-NPs were observed in TEM micrographs. The physico-mechanical finding showed that 5 wt% CeO2-NPs showed the highest concentration of CeO2-NPs and SBS value (18.21±9.06 MPa, p&lt;0.05) simultaneously with no significant differences in ARI compared with the control group (p&gt;0.05). There was a significant reduction in cell viability of S. mutans with increasing CeO2-NPs concentration. The 3.1 Log10 and 4.6 Log10 reductions were observed in the count of treated S. mutans with 5 and 10 wt% CeO2-NPs, respectively (p&lt;0.05).

Conclusions: Overall, an orthodontic adhesive containing 5 wt% CeO2-NPs had antimicrobial properties against S. mutans without adverse effects on SBS and ARI.

Theranostic nanoplatforms of emodin-chitosan with blue laser light on enhancing the anti-biofilm activity of photodynamic therapy against Streptococcus mutans biofilms on the enamel surface

Background

Combining photosensitizer and light irradiation, named antimicrobial photodynamic therapy (aPDT) is an adjuvant therapy for eliminating microbial biofilms. This ex vivo study evaluates the effect of anti-biofilm activity of aPDT based on emodin-chitosan nanoparticles (Emo-CS-NPs) plus blue laser light against Streptococcus mutans biofilm on the enamel surface.

Materials

After determination of the fractional inhibitory concentration index of Emo and CS by checkerboard array assay, Emo-CS-NPs were synthesized and characterized. Following treatment of pre-formed S. mutans biofilms on the enamel slabs, cellular uptake of Emo-CS-NPs and intracellular reactive oxygen species (ROS) production were determined. The anti-biofilm and anti-metabolic activities of aPDT were investigated. Eventually, lactic acid production capacity, concentrations of S. mutans extracellular DNA (eDNA) levels, and expression of the gene involved in the biofilm formation (gtfB) were evaluated.

Results

The maximum uptake of Emo-CS-NPs occurs in an incubation time of 5 min. When irradiated, Emo-CS-NPs were photoactivated, generating ROS, and led to a decrease in the cell viability and metabolic activity of S. mutans significantly (P < 0.05). S. mutans eDNA and lactic acid production outcomes indicated that Emo-CS-NPs-mediated aPDT led to a significant reduction of eDNA levels (48%) and lactic acid production (72.4%) compared to the control group (P < 0.05). In addition, gtfB mRNA expression in S. mutans was downregulated (7.8-fold) after aPDT in comparison with the control group (P < 0.05).

Conclusions

Our data support that, aPDT using Emo-CS-NPs revealed the highest cellular uptake and ROS generation. Emo-CS-NPs based aPDT could inhibit significantly biofilm formation and reduce effectively virulence potency of S. mutans; thus, it could be an adjuvant therapy against dental caries.

Contribution of antimicrobial photo-sonodynamic therapy in wound healing: an in vivo effect of curcumin-nisin-based poly (L-lactic acid) nanoparticle on Acinetobacter baumannii biofilms

BACKGROUND

The biofilm-forming ability of Acinetobacter baumannii in the burn wound is clinically problematic due to the development of antibiotic-resistant characteristics, leading to new approaches for treatment being needed. In this study, antimicrobial photo-sonodynamic therapy (aPSDT) was used to assess the anti-biofilm efficacy and wound healing activity in mice with established A. baumannii infections.

METHODS

Following synthesis and confirmation of Curcumin-Nisin-based poly (L-lactic acid) nanoparticle (CurNisNp), its cytotoxic and release times were evaluated. After determination of the sub-significant reduction (SSR) doses of CurNisNp, irradiation time of light, and ultrasound intensity against A. baumannii, anti-biofilm activity and the intracellular reactive oxygen species (ROS) generation were evaluated. The antibacterial and anti-virulence effects, as well as, histopathological examination of the burn wound sites of treated mice by CurNisNp-mediated aPSDTSSR were assessed and compared with silver sulfadiazine (SSD) as the standard treatment group.

RESULTS

The results showed that non-cytotoxic CurNisNp has a homogeneous surface and a sphere-shaped vesicle with continuous release until the 14th day. The dose-dependent reduction in cell viability of A. baumannii was achieved by increasing the concentrations of CurNisNp, irradiation time of light, and ultrasound intensity. There was a time-dependent reduction in biofilm growth, changes in gene expression, and promotion in wound healing by the acceleration of skin re-epithelialization in mice. Not only there was no significant difference between aPSDTSSR and SSD groups in antibacterial and anti-virulence activities, but also wound healing and re-epithelialization occurred more efficiently in aPSDTSSR than in the SSD group.

CONCLUSIONS

In conclusion, CurNisNp-mediated aPSDT might be a promising complementary approach to treat burn wound infections.

The effects of bimodal action of photodynamic and photothermal therapy on antimicrobial and shear bond strength properties of orthodontic composite containing nano-graphene oxide

BACKGROUND

White spot lesions are a common adverse effect of fixed orthodontic treatment and represent the main challenge to achieving esthetic appearance. The purpose of the current study was to evaluate physico-mechanical and antimicrobial potency of orthodontic composite (OC; Transbond XT) containing nano-structured graphene oxide (nGO) (OC-nGO) as a novel composite following photodynamic therapy (PDT) and photothermal therapy (PTT) against Streptococcus mutans.

MATERIALS AND METHODS

Following preparation of OC-nGO, shear bond strength (SBS) and adhesive remnant index (ARI) of the test OC-nGO (containing 1, 2, 5, and 10% wt. nGO) were measured using a universal testing machine and stereomicroscope, respectively. The antimicrobial activities of test OC contained different concentrations of nGO were determined by disk agar diffusion (DAD), biofilm formation inhibition, and eluted components assays. After continuously rinsed in the aging process (up to 180 days), the antimicrobial activity of OC-nGO containing the highest concentration of nGO which had simultaneously the highest antimicrobial activity and SBS value were determined by DAD, biofilm formation, metabolic activity, and gtfB gene expression assays following photo-activation using diode laser irradiation against S. mutans. Data were analyzed using One-way Analysis of Variance (ANOVA). The Bonferroni post hoc test was used for comparison between the experimental groups. The significant difference was considered at P values < 0.05.

RESULTS

OC with 5% wt. nGO showed simultaneously the highest SBS value (10.64 ± 2.76 MPa, P < 0.05) an antimicrobial and anti-biofilm activities. The OC-nGO in all test concentrations of nGO had ARI scores as same as control group (Transbond XT without the nGO) (P < 0.05). In microbial biofilm formation and gene expression assays, the reduction of photothermal disinfection and anti-virulence activities of the 5% wt. OC-nGO against test bacterium was associated with the time of aging process, so they were reduced significantly up to day 150. Diode laser irradiated 5% wt. OC-nGO suppressed 15.6 and 8.1-fold gtfB mRNA expressions in the biofilm growth of the S. mutans at days 120 and 150 of rinsing (P < 0.05). Microbial biofilm formation and gtfB gene expression in S. mutans at day 180 following PAD had a high level of similarity with OOC as the control group. 5% wt. OC-nGO following photo-activation was not colonized by the S. mutans at day 90 and significant suppressed 91.98% and 76.37% of S. mutans biofilm formation at day 120 and 150, respectively (both P < 0.05). From day 120 onwards, metabolic activity was progressively increased on laser-irradiated 5% wt. OC-nGO discs compared to the control group (OC alone). Photo-activated OC-nGO containing 5% wt. nGO suppressed 86.94% and 46.82% metabolic activity of the S. mutans at days 120 and 150 of rinsing (both P < 0.05).

CONCLUSIONS

Our data support that the photo-activated 5% wt. OC-nGO can serve as an orthodontic composite/adhesive additive to control cariogenic bacterial biofilms.

Synergistic biocidal effects of metal oxide nanoparticles-assisted ultrasound irradiation: Antimicrobial sonodynamic therapy against Streptococcus mutans biofilms

BACKGROUND

Antimicrobial sonodynamic therapy (aSDT) is an adjunctive modality, which uses ultrasound irradiation to kill microbial cells by the activation of a sonosensitizer. The aim of this study was to evaluated the synergistic biocidal effects of zinc oxide nanoparticles (ZnO NPs) and titanium dioxide nanoparticles (TiO₂ NPs) as the metal oxide nanoparticles (MONPs)-assisted ultrasound irradiation against Streptococcus mutans biofilms.

MATERIALS AND METHODS

Following preparation and characterization of MONPs, cellular uptake and generation of intracellular reactive oxygen species (ROS) were assessed. After determination of the sub-significant reduction (SSR) doses of ZnO NPs, TiO₂ NPs, ZnO/TiO₂ NPs, and ultrasound intensity against S. mutans, anti-biofilm effects of aSDT were assessed using colorimetric assay, plate counting, and field emission scanning electron microscope (FESEM) analysis. Also, the metabolic activity of S. mutans and the expression levels of glucosyltransferase B (gtfB) as a main virulence factor of S. mutans were evaluated by XTT assay and quantitative real-time polymerase chain reaction following ZnO/TiO₂ NPs^SSR- mediated aSDT.

RESULTS

The finding of this study showed that an incubation time of 5 min was sufficient to achieve maximal uptake of MONPs. The ROS production following aSDT using ZnO NPs, TiO₂ NPs, and ZnO/TiO₂ NPs were ~ 4.1-, 5.6-, and 11.7-fold increase, respectively. The dose-dependent reduction in cell viability of S. mutans was revealed by increasing the concentrations of ZnO NPs, TiO₂ NPs, ZnO/TiO₂, as well as ultrasound intensities. According to the data, 1.5 µg/mL, 3.1 µg/mL, 25 µg/mL, and 0.75 W/cm² were considered as the SSR doses of ZnO/TiO₂ NPs, ZnO NPs, TiO₂ NPs, and ultrasound intensity, respectively (P>0.05). ZnO/TiO₂ NPs^SSR-mediated aSDT showed a significantly higher biofilm inhibitory activity than the other treatment groups (P<0.05). Based on the FE-SEM analysis, aSDT based on the ZnO/TiO₂ NPs^SSR had a strong anti-biofilm effect against preformed biofilms of S. mutans on the enamel slabs. Also, the metabolic activity of S. mutans and the expression levels of gtfB were significantly decreased to 85.5% and 12.3-fold, respectively following ZnO/TiO₂ NPs^SSR-mediated aSDT (P<0.05). No considerable difference was observed in anti-biofilm activity between ZnO/TiO₂ NPs^SSR- mediated aSDT and 0.2% CHX (P>0.05).

CONCLUSION

The results revealed anti-metabolic and anti-biofilm potential activities of ZnO/TiO₂ NPs-mediated aSDT against S. mutans with the highest cellular uptake and ROS generation.

An orthodontic acrylic resin containing seaweed Ulva lactuca as a photoactive phytocompound in antimicrobial photodynamic therapy: Assessment of anti-biofilm activities and mechanical properties

BACKGROUND

Uncontrolled accumulation of microbial plaque and formation of biofilm on the surface orthodontic acrylic removable appliances increases the risk of enamel decalcification and periodontal diseases. The purpose of the present study was to evaluate antimicrobial activities, anti-virulence potencies, and mechanical properties of orthodontic acrylic resin containing different concentrations of Ulva lactuca (a green marine macroalga) following photo-activation against Streptococcus mutans.

MATERIALS AND METHODS

Minimum inhibitory concentration (MIC) of U. lactuca was determined against S. mutans. Acrylic resin specimens with different concentrations of U. lactuca (0.2 %, 0.5 %, 1%, 2.5 %, 5%, and 10 % weight/weight) were fabricated. Flexural strength values, antimicrobial effects, and anti-biofilm activities of samples were assessed in comparison with original acrylic resin as the control group. Also, the expression of the virulence-associated genes was assessed by quantitative real-time polymerase chain reaction.

RESULTS

U. lactuca at concentrations of 1-10% significantly reduced the S. mutans growth rate by 20.3%-63.3% in comparison to the control group (P < 0.05). Therefore, the concentration of 1% of U. lactuca was considered as a MIC. The highest and lowest flexural strength values were observed in the control group (43.5 ± 2.4 MPa) and the group with a 10 % concentration of U. lactuca (19.2 ± 1.8 MPa), respectively. Flexural strength values decreased in samples containing 2.5 %, 5%, and 10 % concentrations of U. lactuca in comparison to the control group significantly (P > 0.05). In the disc agar diffusion test, the growth inhabitation zones around samples containing different concentrations of photo-activated U. lactuca ranged from 13 mm to 25 mm in diameter. Interestingly, the anti-biofilm activity of U. lactuca-mediated aPDT against S. mutans was dose-dependent. Additionally, the sub-MIC dose of U. lactuca (0.5 %) following photo-activation could significantly decrease the expression levels of gtfB, gtfC, and gtfD to 4.1-, 5.3-, and 7.4-fold, respectively.

CONCLUSIONS

Adding photo-activated U. lactuca to the orthodontic acrylic resin at a concentration of 1% increases its antibacterial and anti-biofilm activities besides not detrimentally affects its flexural strength.

Propolis nanoparticle enhances the potency of antimicrobial photodynamic therapy against Streptococcus mutans in a synergistic manner

Less invasive removal approaches have been recommended for deep caries lesions. Antimicrobial photodynamic therapy (aPDT) and propolis nanoparticle (PNP) are highlighted for the caries management plan. Evidence is lacking for an additive effect of combination PNP with photosensitizer (PS) in aPDT. This study aimed to investigate the individual and synergistic effects of chlorophyllin-phycocyanin mixture (PhotoActive⁺) and toluidine blue O (TBO) as PSs in combination with PNP in the aPDT process (aPDT^plus) against major important virulence factors of Streptococcus mutans. Following characterization, biocompatibility of the PSs alone, or in combination with PNP were investigated on human gingival fibroblast cell. The in vitro synergy of PhotoActive⁺ or TBO and PNP was evaluated by the checkerboard method. The bacteria's virulence properties were surveyed in the presence of the PSs, individually as well as in combination. When the PSs were examined in combination (synergistic effect, FIC Index < 0.5), a stronger growth inhibitory activity was exhibited than the individual PSs. The biofilm formation, as well as genes involved in biofilm formation, showed greater suppression when the PSs were employed in combination. Overall, the results of this study suggest that the combination of PhotoActive⁺ or TBO with PNP with the least cytotoxicity effects and the highest antimicrobial activites would improve aPDT outcomes, leading to synergistic effects and impairing the virulence of S. mutans.

Sonodynamic excitation of nanomicelle curcumin for eradication of Streptococcus mutans under sonodynamic antimicrobial chemotherapy: Enhanced anti-caries activity of nanomicelle curcumin

BACKGROUND

Inactivation of microorganisms related to dental caries has been considered the therapy of choice in the treatment of caries. The proposed study aims to assess the effect of sonodynamic excitation of nanomicelle curcumin (NM@Cur) compared to Cur for eradication of Streptococcus mutans under sonodynamic antimicrobial chemotherapy (SACT).

MATERIALS AND METHODS

The NM@Cur as a sonosensitizer was synthesized and its morphology, particle size distribution, zeta potential, and physical stability were then determined. After evaluating the Cur and NM@Cur uptake in S. mutans strain, Cur- and NM@Cur-SACT effects were determined on colony forming unit (CFU/mL) and reactive oxygen species (ROS) levels. Additionally, cytotoxicity and apoptotic effects of Cur- and NM@Cur-SACT on human gingival fibroblast (HGF) cells were assessed using MTT assay and flow cytometry analysis, respectively.

RESULTS

Transmission electron microscope, particle size distribution, and zeta potential analysis confirmed successful synthesis of NM@Cur. The finding of this study showed that an incubation time of 5 min to 1 h was sufficient to achieve maximal uptake of Cur and NM@Cur in S. mutans. SACT with Cur at a concentration of 50 mM and ultrasound intensity at 1.56 W/cm² for 1 min significantly reduced the count of S. mutans to 90.8 %, compared to control group (P < 0.05), while the count of S. mutans decreased to 99.9 % following treatment with the NM@Cur-SACT (P < 0.05), that was also confirmed via fluorescence microscopy. As well as, SACT with 50 mM NM@Cur not only had the least toxicity against HGF cells, but also showed 10.8-fold increase in intracellular ROS production.

CONCLUSIONS

Overall, this study revealed that NM@Cur-mediated SACT with the least cytotoxicity and apoptotic effects and the highest cellular uptake, ROS production, and antimicrobial activites could effectively inhibit the growth of the S. mutans in compare with Cur.

The impact of Aggregatibacter actinomycetemcomitans biofilm-derived effectors following antimicrobial photodynamic therapy on cytokine production in human gingival fibroblasts

BACKGROUND

Antimicrobial photodynamic therapy (aPDT) is an effective adjunctive therapeutic modality for the treatment of local infections, including periodontitis and peri-implantitis. After receiving aPDT, microbial cells in the biofilm structure may produce and/ or release soluble biofilm-derived effectors (BDEs), which may affect the biology of the host cells in the community context of their surrounding microenvironment. Given the fact that no study has investigated the role of BDEs following aPDT in the pathogenesis of infectious diseases, the aim of the current study was to determine the effect of BDEs of Aggregatibacter actinomycetemcomitans following exposure to sub-lethal doses of indocyanine green (ICG)-aPDT on human gingival fibroblasts (HGFs) in terms of cytokines produced.

MATERIALS AND METHODS

In this study, we evaluated the effect of biofilm-conditioned medium (BCM) resulting from the treatment of A. actinomycetemcomitans biofilm with a sub-lethal dose of aPDT on cytokines production, including IL-6, IL-8, CXCL10, TGF-β, and bFGF of HGFs using enzyme-linked immunoassays (ELISA). The sensitivity of cytokines to BDEs was determined by micro-titer plates.

RESULTS

The maximal sub-lethal dose of ICG-PDT was 20.15 μM/mL ICG at a fluence of 31.2 J/cm². The BCM of ICG-PDT-treated viable A. actinomycetemcomitans significantly reduced IL-6, IL-8, and CXCL10 levels compared to the BCM of untreated viable A. actinomycetemcomitans (78-, 93-, and 61.6-fold reduction, respectively; all P < 0.01). TGF-β and bFGF were strongly induced by BCM of ICG-PDT treated viable A. actinomycetemcomitans (by 57.7 and 36.1 folds, respectively; both P < 0.05). The BCM of untreated viable A. actinomycetemcomitans degraded most of the CxCL10, TGF-β and bFGF (58.8, 61.5, and 71.6%, respectively) in 24 h, while it degraded 9.3% of IL-6 and 15.1% of IL-8 after 24 h.

CONCLUSION

The results of the current study revealed that a sub-lethal dose of ICG-aPDT through the effect of BCM on HGFs could not only significantly reduce the production of pro-inflammatory cytokines but also promoted their role in periodontal regeneration due to increasing the bFGF level. Altogether, ICG-aPDT, with it's antimicrobial effects reduces inflammation and induces of tissue regeneration resulting from BCM, can be considered an efficient adjunctive therapeutic method for the treatment of local infections.