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Alberti A, Corbella S, Taschieri S, Francetti L, Fakhruddin KS, Samaranayake LP. Fungal species in endodontic infections: A systematic review and meta-analysis. PLoS One 2021; 16:e0255003. [PMID: 34293029 PMCID: PMC8297845 DOI: 10.1371/journal.pone.0255003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/07/2021] [Indexed: 12/30/2022] Open
Abstract
Fungal infections are common on oral mucosae, but their role in other oral sites is ill defined. Over the last few decades, numerous studies have reported the presence of fungi, particularly Candida species in endodontic infections, albeit in relatively small numbers in comparison to its predominant anaerobic bacteriome. Here, we review the fungal biome of primary and secondary endodontic infections, with particular reference to the prevalence and behavior of Candida species. Meta-analysis of the available data from a total of 39 studies fitting the inclusion criteria, indicate the overall weighted mean prevalence (WMP) of fungal species in endodontic infections to be 9.11% (from a cumulative total of 2003 samples), with 9.0% in primary (n = 1341), and 9.3% in secondary infections (n = 662). Nevertheless, WMP for fungi in primary and secondary infections which were 6.3% and 7.5% for culture-based studies, increased to 12.5% and 16.0% in molecular studies, respectively. The most prevalent fungal species was Candida spp. The high heterogeneity in the reported fungal prevalence suggests the need for standardized sampling, and speciation methods. The advent of the new molecular biological analytical platforms, such as the next generation sequencing (NGS), and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF), that enables identification and quantitation of a broad spectrum of hitherto unknown organisms in endodontic infections should radically alter our understanding of the endodontic mycobiome in the future. Candida spp. appear to be co-pathogens with bacteria in approximately one in ten patients with endodontic infections. Hence, clinicians should comprehend the importance and the role of fungi in endodontic infections and be cognizant of the need to eradicate both bacteria and fungi for successful therapy.
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Affiliation(s)
- Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- * E-mail:
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Lakshman Perera Samaranayake
- College of Dental Medicine, University of Sharjah, Sharjah, UAE
- The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
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Guo H, Chen Y, Guo W, Chen J. Effects of extracellular DNA on dual-species biofilm formed by Streptococcus mutans and Candida albicans. Microb Pathog 2021; 154:104838. [PMID: 33691176 DOI: 10.1016/j.micpath.2021.104838] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/28/2021] [Accepted: 02/25/2021] [Indexed: 12/12/2022]
Abstract
Streptococcus mutans is the most important acid-producing pathogen that causes dental caries, while Candida albicans is an opportunistic fungal pathogen that is frequently detected in conjunction with heavy infection by S. mutans. Their interactions in dental plaque biofilms remain unclear. Extracellular DNA (eDNA) is found in oral biofilms, but its effects have not been thoroughly defined. In this study, the role of eDNA in dual-species biofilms formed by S. mutans and C. albicans was investigated. With eDNA removal, the growth of both strains was not affected, but the formation of dual-species biofilms obviously decreased. In addition, the removal of eDNA spatially disrupted the structure of the dual-species biofilm. It was also shown that eDNA mainly affected the initial attachment and development stages of the dual-species biofilms but not the well-developed biofilms. A similar phenomenon was also observed in the cell viability of dual-species biofilms after DNase I treatment. To further exploration, we analyzed the expression of genes associated with biofilm formation in both S. mutans and C. albicans. We determined that the co-cultivation of S. mutans and C. albicans promotes the expression of genes related to extracellular polysaccharide production (e.g., gtfC), adhesion (e.g., spaP, epa1), mycelial transformation (e.g., hwp1), and drug resistance (e.g., cdr2). However, these genes were significantly downregulated when the eDNA of the dual-species biofilm was removed by adding DNase I compared to those untreated groups. Altogether, eDNA removal, such as that by DNase I treatment, could be considered a promising strategy to control oral biofilms and biofilm-associated oral diseases.
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Affiliation(s)
- Haoran Guo
- Beijing Laboratory for Food Quality and Safety, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Yitong Chen
- Beijing Laboratory for Food Quality and Safety, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Wenjin Guo
- Beijing Chong Wen Stomatological Hospital, Beijing, 100062, China
| | - Jingyu Chen
- Beijing Laboratory for Food Quality and Safety, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China.
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Charone S, Portela MB, Martins KDO, Soares RM, Castro GF. Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study. J Appl Oral Sci 2017; 25:53-60. [PMID: 28198976 PMCID: PMC5289400 DOI: 10.1590/1678-77572016-0021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 09/23/2016] [Indexed: 02/07/2023] Open
Abstract
Objectives This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Material and Methods Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. Results TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Conclusion Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro.
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Affiliation(s)
- Senda Charone
- Universidade Federal do Rio de Janeiro, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia, Rio de Janeiro, RJ, Brasil.,Universidade de Brasília, Faculdade de Odontologia, Departamento de Cariologia, Brasília, DF, Brasil
| | - Maristela Barbosa Portela
- Universidade Federal Fluminense, Faculdade de Odontologia, Departamento de Clínica e Odontopediatria, Niterói, RJ, Brasil
| | - Karol de Oliveira Martins
- Universidade Federal Fluminense, Faculdade de Odontologia, Departamento de Clínica e Odontopediatria, Niterói, RJ, Brasil
| | - Rosangela Maria Soares
- Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Paulo de Góes, Departamento de Microbiologia, Rio de Janeiro, RJ, Brasil
| | - Gloria Fernanda Castro
- Universidade Federal do Rio de Janeiro, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia, Rio de Janeiro, RJ, Brasil
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Xin W, Leung KCM, Lo ECM, Mok MY, Leung MH. A randomized, double-blind, placebo-controlled clinical trial of fluoride varnish in preventing dental caries of Sjögren's syndrome patients. BMC Oral Health 2016; 16:102. [PMID: 27664129 PMCID: PMC5034648 DOI: 10.1186/s12903-016-0296-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 09/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sjögren's syndrome (SS) patients are prone to caries development due to reduction of salivary flow. Topical fluoride is commonly prescribed for caries prevention. METHODS In this 24-month randomized, double-blind, placebo-controlled clinical trial, SS patients were randomly assigned to receive either fluoride varnish or placebo gel quarterly. Development and arrest of caries at the coronal and root surfaces were recorded at 12-month and 24-month and compared to that of the baseline. Effect of fluoride varnish on oral Candida and lactobacilli colonization was explored by comparing baseline oral microbiological assessments to data obtained at 12-month and 24-month. RESULTS Seventy-eight SS patients (mean age = 50 years, 2 men) completed this trial. At 24-month, the mean new coronal enamel caries were 1.6 surfaces in both groups, and new dentin caries were 1.4 and 2.7 surfaces in the fluoride and placebo group respectively (p > 0.05). Mean arrested caries were 0.6 and 0.7 surfaces for fluoride and placebo groups respectively and that of root caries were 0.3 and 0.1 surfaces (p > 0.05). The mean oral Candida count was reduced by 30 % in the fluoride group but increased 61 % in the placebo group while no change in oral lactobacilli counts in both groups at 24 months (p > 0.05). SS patients receiving fluoride varnish were significantly less likely to develop dentin caries (p < 0.05). In contrast, those with high baseline DMFS scores (p = 0.05), harbored mixed Candida species (p < 0.05), or unstimulated whole saliva at low pH (p < 0.01) were significantly more likely to develop dentin caries. CONCLUSIONS Results of this randomized clinical trial did not provide clear evidence to support or refute that quarterly applications of fluoride varnish can prevent development of dental caries in people with Sjögren's syndrome. TRIAL REGISTRATION This study was retrospectively registered at the ISRCTN registry ( ISRCTN85164658 ) on 9 Sept 2016 and was funded by the Research Grant Council of Hong Kong.
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Affiliation(s)
- Weini Xin
- Dental Care Center, The No.1 Affiliated Hospital of Shantou Medical College, Shantou, China
| | | | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Mo Yin Mok
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Moon Ho Leung
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
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Yang XQ, Zhang Q, Lu LY, Yang R, Liu Y, Zou J. Genotypic distribution of Candida albicans in dental biofilm of Chinese children associated with severe early childhood caries. Arch Oral Biol 2012; 57:1048-53. [PMID: 22717324 DOI: 10.1016/j.archoralbio.2012.05.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 05/18/2012] [Accepted: 05/21/2012] [Indexed: 11/29/2022]
Abstract
AIM Candida albicans causes a wide range of infections in the oral mucosa, especially candidiasis. A strong association has been found between C. albicans and dental caries. In this study, we investigated the presence and genotypic distribution of C. albicans in the dental biofilm of Chinese children with severe early childhood caries (S-ECC). DESIGN Dental biofilm samples were collected from 41 Chinese children (21 children with S-ECC and 20 children without caries) aged 3-6 years. Samples collected were cultured in CHROMagar Candida (CA) medium. Cellular DNA of typical C. albicans isolates in the CA medium was isolated, and PCR using primers reported to span a transposable intron region in the 25S rRNA gene was performed to determine genotypic subgroups. RESULTS C. albicans was detected in 57.1% of individuals with S-ECC. Additionally, three genotypic subgroups of C. albicans (genotypes A, B, and C) were found in children with S-ECC, and genotype A was dominant. CONCLUSIONS C. albicans is an important component of dental biofilm associated with S-ECC, and C. albicans genotypic subgroup A is the dominant strain in the dental biofilm of children with S-ECC.
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Affiliation(s)
- Xiao Qiong Yang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
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Ballal NV, Yegneswaran PP, Mala K, Bhat KS. In vitro antimicrobial activity of maleic acid and ethylenediaminetetraacetic acid on endodontic pathogens. ACTA ACUST UNITED AC 2011; 112:696-700. [PMID: 21872510 DOI: 10.1016/j.tripleo.2011.05.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 05/27/2011] [Accepted: 05/29/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the antimicrobial efficacy of 7% maleic acid (MA) and 17% ethylenediaminetetraacetic acid (EDTA) in elimination of Enterococcus faecalis, Candida albicans, and Staphylococcus aureus at different time intervals. STUDY DESIGN Transfer culture of microbial strains were used for inoculum preparation and determination of time-kill assay. The viability counts of 7% MA and 17% EDTA suspensions were performed at 0, 2, 4, 6, 12, and 24 hours. Assay results were analyzed by determining number of strains that yielded log(10) CFU/mL of -1 compared with counts at 0 hours, for test medicaments at time intervals. Medicaments were considered to be microbicidal at a minimum inhibitory concentration that reduced original inoculum by >3 log(10) CFU/mL (99.9%) and microbiostatic if inoculum was reduced by <3 log(10) CFU/mL. Statistical analysis was performed using chi-square and Fisher exact tests as well as Friedman test for comparison of the time interval within the MA and EDTA groups. RESULTS At all time intervals, there was no significant difference between MA and EDTA for all of the organisms (P > .05). However, within the MA and EDTA groups at various time intervals, there were significant differences (P < .001). CONCLUSIONS Equivalent antimicrobial activity was observed by MA and EDTA against all of the organisms tested at various periods.
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Affiliation(s)
- Nidambur Vasudev Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal University, Manipal, India.
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Maijala M, Rautemaa R, Järvensivu A, Richardson M, Salo T, Tjäderhane L. Candida albicans does not invade carious human dentine. Oral Dis 2007; 13:279-84. [PMID: 17448209 DOI: 10.1111/j.1601-0825.2006.01279.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Candida albicans has been proposed to be a caries pathogen, but the evidence for its specific role is lacking. To be considered significant in caries progression, a marked amount of yeasts should be present in a lesion. The aim of the study was to investigate the presence of C. albicans in dentinal caries lesions. MATERIALS AND METHODS To demonstrate the extension of caries and to identify the bacteria in a lesion, sections of 10 carious human teeth were stained with Gram and Giemsa stains. C. albicans was detected with periodic acid-Schiff (PAS) staining and by immunohistochemistry using a C. albicans-specific antibody 3H8. Thirty sections were used for each staining (in total 120 sections). RESULTS Extensive bacterial invasion and intensive staining by PAS occurred in all samples. However, with the C. albicans-specific antibody, only 30 (3.3%) sections stained weakly positive, with a few stained cells on the lesion surface. However, the positive identification of C. albicans, based on the morphology of the cells, was not possible. CONCLUSIONS The results do not support the previous suggestion that C. albicans is important in the dentine caries pathology. In addition, because of its unspecific nature, PAS turned out to be an unsuitable method for detecting yeasts in carious tooth samples.
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Affiliation(s)
- M Maijala
- Institute of Dentistry, University of Helsinki, Helsinki, Finland
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Consolaro MEL, Gasparetto A, Svidzinski TIE, Peralta RM. Effect of pepstatin A on the virulence factors of Candida albicans strains isolated from vaginal environment of patients in three different clinical conditions. Mycopathologia 2006; 162:75-82. [PMID: 16897584 DOI: 10.1007/s11046-006-0026-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2005] [Accepted: 03/23/2006] [Indexed: 11/30/2022]
Abstract
The aspartate proteinase inhibitor pepstatin A was used to study a possible correlation among proteinase activity and other virulence factors of Candida albicans strains isolated from the vaginal environment of patients in three different clinical conditions: asympthomatic, vulvovaginal candidiasis (VVC) and recurrent vulvovaginal candidiasis (RVVC). The addition of 1.0 muM pepstatin A did not have any significant effect on hyphae formation, biofilm production and in the cell surface hydrofobicity of isolates in the three different clinical conditions. However, pepstatin A reduced the adherence of C. albicans to vaginal mucosa epithelial cells (53.1, 48.7 and 59.9%, respectively to isolates from asymptomatic, VVC and RVVC patients). This result suggests that the secreted aspartate proteinases (Saps) of this fungal pathogen may have auxiliary roles in cellular adhesion.
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Affiliation(s)
- M E L Consolaro
- Division of Medical Mycology, Teaching and Research in Clinical Analysis Laboratory, State University of Maringá, Maringá, Paraná, Brazil
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Ates M, Akdeniz BG, Sen BH. The effect of calcium chelating or binding agents on Candida albicans. ACTA ACUST UNITED AC 2005; 100:626-30. [PMID: 16243251 DOI: 10.1016/j.tripleo.2005.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Revised: 03/04/2005] [Accepted: 03/10/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate antifungal effects of calcium-chelating or -binding agents on Candida albicans comparing with conventional antifungal agents. STUDY DESIGN Two clinical oral isolates and 1 standard strain of C albicans were included in the study. Test solutions were ethylenediamine-tetraacetic acid (EDTA), ethyleneglycol-tetraacetic acid (EGTA), sodium fluoride (NaF), titanium tetrafluoride (TiF4), nystatin, and ketoconazole. Minimum inhibitory and fungicidal concentrations of the solutions were determined. The results were analyzed statistically using Friedman's nonparametric 2-way ANOVA and Mann-Whitney U tests. RESULTS All isolates demonstrated similar susceptibility patterns (P>.05). Except ketoconazole, EDTA had the highest antifungal and fungicidal activity, followed by TiF4. EGTA and NaF were the weakest agents against C albicans among all test solutions. CONCLUSION EDTA and TiF4 may be recommended as an alternative irrigating solution particularly in persistent root canal infections and in root canals of patients having a high incidence of oral candidosis.
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Affiliation(s)
- Mustafa Ates
- Department of Biology, Division of Basic and Industrial Microbiology, School of Science, Ege University, Izmir, Turkey
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Nikawa H, Yamashiro H, Makihira S, Nishimura M, Egusa H, Furukawa M, Setijanto D, Hamada T. In vitro cariogenic potential of Candida albicans. Mycoses 2004; 46:471-8. [PMID: 14641620 DOI: 10.1046/j.0933-7407.2003.00888.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The adherence and dissociation of Candida albicans, C. tropicalis, Streptococcus mutans and S. sanguis to six substrates including hydroxylapatite (HAP) which exhibit various hydrophobicity, was examined by the use of a bioluminescent adenosine triphosphate (ATP) assay. Dissolution of HAP by C. albicans or S. mutans was determined spectrophotometrically by the use of o-cresolphthalein complexone. In the adherence of C. tropicalis, S. mutans and S. sanguis, the amount of adherent cells correlated with the hydrophobicity of the substrates. In contrast, the adherence of C. albicans to HAP was extraordinary high, although the adherence of the fungi also correlated with the hydrophobicity of the substrates, except for HAP. The yeasts attached to HAP was effectively removed by high concentration of either phosphate or calcium ions. The amount of calcium-release from HAP caused by C. albicans and S. mutans was 113 microg ml(-1) (final pH = 3.45), and 5.4 microg ml(-1) (final pH 4.81), respectively and the maximum growth of C. albicans and S. mutans was 10(7) cfu ml(-1) and 7.4 x 10(12) cfu ml(-1), respectively. The results, taken together, suggest that C. albicans adhere to HAP specifically through electrostatic interaction, and that, in a much smaller number (1.0/7.4 x 10(5)), C. albicans possesses the ability to dissolve HAP to a greater extent (approximately 20-fold) when compared with S. mutans.
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Affiliation(s)
- H Nikawa
- Department of Prosthetic Dentistry, Hiroshima University Faculty of Dentistry, Hiroshima, Japan.
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Current awareness. Yeast 2002; 19:903-8. [PMID: 12112243 DOI: 10.1002/yea.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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