Anti-biofilm activity of a novel pit and fissure self-adhesive sealant modified with metallic monomers

Antimicrobial photodynamic therapy against a dual-species cariogenic biofilm using a ruthenium-loaded resin-based dental material

BACKGROUND

Streptococcus mutans and Candida albicans are associated with caries recurrence. Therefore, this study evaluated the combination of a Ru(II)-loaded resin-based dental material (RDM) and antimicrobial photodynamic therapy (aPDT) against a dual-species biofilm of S. mutans and C. albicans.

METHODS

An aPDT protocol was established evaluating Ru(II)'s photocatalytic activity and antimicrobial potential under blue LED irradiation (440-460 nm, 22.55 mW/cm2) at different energy densities (0.00, 6.25, 20.25, 40.50 J/cm2). This evaluation involved singlet oxygen quantification and determination of minimum inhibitory concentration (MIC) and minimum bactericidal/fungicidal concentration (MBC/MFC). The biofilm was grown (72 h) on resin disks prepared with Ru(II)-doped RDM (0.00, 0.56, or 1.12 %) and samples were exposed to aPDT or dark conditions. The biofilm was then harvested to analyze cell viability (CFU counts) and formation of soluble and insoluble exopolysaccharides.

RESULTS

The photocatalytic activity of Ru(II) was concentration and energy density dependent (p < 0.05), and MIC/MBC values were reduced for the microorganisms after LED irradiation (40.5 J/cm2); therefor, this energy density was chosen for aPDT. Although incorporation of Ru(II) into RDM reduced the biofilm growth compared to Ru(II)-free RDM for both species in dark conditions (p < 0.05), aPDT combined with an Ru(II)-loaded RDM (0.56 or 1.12 %) potentialized CFU reductions (p < 0.05). Conversely, only 1.12 % Ru(II) with LED irradiation showed lower levels of both soluble and insoluble exopolysaccharides compared to Ru(II)-free samples in dark conditions (p < 0.05).

CONCLUSIONS

When the Ru(II)-loaded RDM was associated with blue LED, aPDT reduced cell viability and lower soluble and insoluble exopolysaccharides were found in the cariogenic dual-species biofilm.

Antifungal efficiency and cytocompatibility of polymethyl methacrylate modified with zinc dimethacrylate

Objectives

Considering the high incidence rates of denture stomatitis, research that providing dental biomaterials with antifungal property are essential for clinical dentistry. The objectives of the present study were to investigate the effect of zinc dimethacrylate (ZDMA) modification on the antifungal and cytotoxic properties, as well as the variance in surface characteristics and other physicochemical properties of polymethyl methacrylate (PMMA) denture base resin.

Methods

PMMA with various mass fraction of ZDMA (1 wt%, 2.5 wt% and 5 wt%) were prepared for experimental groups, and unmodified PMMA for the control. Fourier-transform infrared spectroscopy (FTIR) was applied for characterization. Thermogravimetric analysis, atomic force microscopy and water contact angle were performed to investigate the thermal stability and surface characteristics (n=5). Antifungal capacities and cytocompatibility were evaluated with Candida albicans (C. albicans) and human oral fibroblasts (HGFs), respectively. Colony-forming unit counting, crystal violet assay, live/dead biofilm staining and scanning electron microscopy observation were performed to assess antifungal effects, and the detection of intracellular reactive oxygen species production was applied to explore the possible antimicrobial mechanism. Finally, the cytotoxicity of ZDMA modified PMMA resin was evaluated by the 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay and live/dead double staining.

Results

The FTIR analyses confirmed some variation in chemical bonding and physical blend of the composites. Incorporation of ZDMA significantly enhanced the thermal stability and hydrophilicity compared with unmodified PMMA (p < 0.05). The surface roughness increased with the addition of ZDMA while remained below the suggested threshold (≤ 0.2 µm). The antifungal activity significantly improved with ZDMA incorporation, and cytocompatibility assays indicated no obvious cytotoxicity on HGFs.

Conclusions

In the present study, the ZDMA mass fraction up to 5 wt% in PMMA performed better thermal stability, and an increase in surface roughness and hydrophilicity without enhancing microbial adhesion. Moreover, the ZDMA modified PMMA showed effective antifungal activity without inducing any cellular side effects.

Effect of alpha-humulene incorporation on the properties of experimental light-cured periodontal dressings

The objective of this study was to formulate an experimental light-cured periodontal dressing containing alpha-humulene and to compare its physical, antimicrobial, and cytotoxicity properties with commercial gold standards (Barricaid® and Periobond®). Two periodontal dressing formulations were developed (a and b). The formulations were divided into 5 groups according to the alpha-humulene concentration as follows: Ea - control group, Ea1 - 1%, Ea5 - 5%, Ea10 - 10%, and Ea20 - 20%; Eb - control group, Eb1 - 1%, Eb5 - 5%, Eb10 - 10%, and Eb20 - 20%. Materials characterization was performed using the degree of conversion, cohesive strength, sorption, and solubility assays. Antimicrobial assay was performed using the modified direct contact test against E. faecalis and S. aureus. Cytotoxicity was assessed by the cell viability experiment using L929 fibroblasts. In general, the cohesive strength values of materials decreased as the alpha-humulene concentration increased. All the experimental dressings showed antimicrobial activity against both bacteria tested. Cell viability results for the Ea, Ea1, Eb, and Eb1 groups showed moderate cytotoxic effect. The formulations containing alpha-humulene showed similar behavior to the commercial references. Thus, formulations containing alpha-humulene have potential to be used as periodontal dressing.

In it together: Candida-bacterial oral biofilms and therapeutic strategies

Under natural environmental settings or in the human body, the majority of microorganisms exist in complex polymicrobial biofilms adhered to abiotic and biotic surfaces. These microorganisms exhibit symbiotic, mutualistic, synergistic, or antagonistic relationships with other species during biofilm colonization and development. These polymicrobial interactions are heterogeneous, complex and hard to control, thereby often yielding worse outcomes than monospecies infections. Concerning fungi, Candida spp., in particular, Candida albicans is often detected with various bacterial species in oral biofilms. These Candida-bacterial interactions may induce the transition of C. albicans from commensal to pathobiont or dysbiotic organism. Consequently, Candida-bacterial interactions are largely associated with various oral diseases, including dental caries, denture stomatitis, periodontitis, peri-implantitis, and oral cancer. Given the severity of oral diseases caused by cross-kingdom consortia that develop hard-to-remove and highly drug-resistant biofilms, fundamental research is warranted to strategically develop cost-effective and safe therapies to prevent and treat cross-kingdom interactions and subsequent biofilm development. While studies have shed some light, targeting fungal-involved polymicrobial biofilms has been limited. This mini-review outlines the key features of Candida-bacterial interactions and their impact on various oral diseases. In addition, current knowledge on therapeutic strategies to target Candida-bacterial polymicrobial biofilms is discussed.

Novel polymethyl methacrylate modified with metal methacrylate monomers: biological, physicomechanical, and optical properties

This study sought to evaluate the physical and antimicrobial properties of a thermopolymerizable acrylic resin (PMMA) modified with metallic methacrylate monomers -zirconia (ZM), tin (TM), and di-n-butyl (DNTMB) methacrylates. Color stability was evaluated before and after immersion of samples in a staining solution by a digital spectrophotometer. The mechanical brushing test was evaluated by the roughness test. The flexural strength test used a mechanical testing machine. Human keratinocytes were used to assess cell viability and the biofilm formation assay was carried out for 5 days, in a microcosms model after one year of specimen storage. For statistical analysis, the method chosen was based on adherence to the normal distribution model and equality of variances (p < 0.05). The addition of DNTMB to PMMA promoted great antimicrobial action, acceptable cytocompatibility, without hampering the physical-mechanical properties of the commercial material. Therefore, the modified PMMA proved to be a promisor alternative to conventional resins.This study sought to evaluate the physical and antimicrobial properties of a thermopolymerizable acrylic resin (PMMA) modified with metallic methacrylate monomers -zirconia (ZM), tin (TM), and di-n-butyldimethacrylate-tin (DNTMB) methacrylates. Color stability was evaluated before and after immersion of samples in a staining solution using a digital spectrophotometer. The mechanical brushing test was evaluated by the roughness test. The flexural strength test used a mechanical testing machine. Human keratinocytes were used to assess cell viability and the biofilm formation assay was carried out for 5 days in a microcosm model after one year of specimen storage. For statistical analysis, the method chosen was based on adherence to the normal distribution model and equality of variances (p < 0.05). The addition of DNTMB to PMMA promoted great antimicrobial action, acceptable cytocompatibility, without hampering the physical-mechanical properties of the commercial material. Therefore, the modified PMMA proved to be a promising alternative to conventional denture base resins for dental use.

Recent Advances and Opportunities in the Study of Candida albicans Polymicrobial Biofilms

It is well known that the opportunistic pathogenic yeast, Candida albicans, can form polymicrobial biofilms with a variety of bacteria, both in vitro and in vivo, and that these polymicrobial biofilms can impact the course and management of disease. Although specific interactions are often described as either synergistic or antagonistic, this may be an oversimplification. Polymicrobial biofilms are complex two-way interacting communities, regulated by inter-domain (inter-kingdom) signaling and various molecular mechanisms. This review article will highlight advances over the last six years (2016-2021) regarding the unique biology of polymicrobial biofilms formed by C. albicans and bacteria, including regulation of their formation. In addition, some of the consequences of these interactions, such as the influence of co-existence on antimicrobial susceptibility and virulence, will be discussed. Since the aim of this knowledge is to inform possible alternative treatment options, recent studies on the discovery of novel anti-biofilm compounds will also be included. Throughout, an attempt will be made to identify ongoing challenges in this area.

Bimodal Nanocomposite Platform with Antibiofilm and Self-Powering Functionalities for Biomedical Applications

Advances in microelectronics and nanofabrication have led to the development of various implantable biomaterials. However, biofilm-associated infection on medical devices still remains a major hurdle that substantially undermines the clinical applicability and advancement of biomaterial systems. Given their attractive piezoelectric behavior, barium titanate (BTO)-based materials have also been used in biological applications. Despite its versatility, the feasibility of BTO-embedded biomaterials as anti-infectious implantable medical devices in the human body has not been explored yet. Here, the first demonstration of clinically viable BTO-nanocomposites is presented. It demonstrates potent antibiofilm properties against Streptococcus mutans without bactericidal effect while retaining their piezoelectric and mechanical behaviors. This antiadhesive effect led to ∼10-fold reduction in colony-forming units in vitro. To elucidate the underlying mechanism for this effect, data depicting unfavorable interaction energy profiles between BTO-nanocomposites and S. mutans using the classical and extended Derjaguin, Landau, Verwey, and Overbeek theories is presented. Direct cell-to-surface binding force data using atomic force microscopy also corroborate reduced adhesion between BTO-nanocomposites and S. mutans. Interestingly, the poling process on BTO-nanocomposites resulted in asymmetrical surface charge density on each side, which may help tackle two major issues in prosthetics-bacterial contamination and tissue integration. Finally, BTO-nanocomposites exhibit superior biocompatibility toward human gingival fibroblasts and keratinocytes. Overall, BTO-embedded composites exhibit broad-scale potential to be used in biological settings as energy-harvestable antibiofilm surfaces.

Dental Sealant Composition-Retention Assessment in Young Permanent Molars

Tooth decay in children and adolescents remains a public health problem, despite prophylaxis and preventive measures being largely available. The aim of our study was to evaluate the clinical behavior of four dental sealants, related to first permanent molar topography and patient age (when sealant was applied for the first time). We assessed, by means of visual inspection and palpation with a dental probe, a group of 200 children, enrolled corresponding to school age-grade (mean age of 7 years at baseline) and randomly divided according to the material used as dental sealant (Admira seal©, Embrace Wet Bond©, Fotoseal©, GC Fuji Triaje©) in 4 groups (n = 50). Sealant clinical evaluation was made at 6-, 12-, 18-month intervals for dental material retention assessment. At 6 months, the sealant detached the most from 3.6 molars, and the material used was Fotoseal© (27.6%). At 12 months, Fotoseal© (48.3%) and GC Fuji Triaje© (41.4%) from 3.6 molars express detachment. At 18 months, 4.6. molars sealed with Admira Seal© (25.7%) and Embrace Wet Bond© (28.6%) lost the sealant. We noticed less detachment in maxillary molars and if sealant was applied around 7 years of age. In conclusion, sealant application on first permanent molars must be encouraged and practitioners can choose between various materials available.

Synergism of Streptococcus mutans and Candida albicans Reinforces Biofilm Maturation and Acidogenicity in Saliva: An In Vitro Study

Early childhood caries, a virulent-form of dental caries, is painful, difficult, and costly to treat that has been associated with high levels of Streptococcus mutans (Sm) and Candida albicans (Ca) in plaque-biofilms on teeth. These microorganisms appear to develop a symbiotic cross-kingdom interaction that amplifies the virulence of plaque-biofilms. Although biofilm studies reveal synergistic bacterial-fungal association, how these organisms modulate cross-kingdom biofilm formation and enhance its virulence in the presence of saliva remain largely unknown. Here, we compared the properties of Sm and Sm-Ca biofilms cultured in saliva by examining the biofilm structural organization and capability to sustain an acidic pH environment conducive to enamel demineralization. Intriguingly, Sm-Ca biofilm is rapidly matured and maintained acidic pH-values (~4.3), while Sm biofilm development was retarded and failed to create an acidic environment when cultured in saliva. In turn, the human enamel slab surface was severely demineralized by Sm-Ca biofilms, while there was minimal damage to the enamel surface by Sm biofilm. Interestingly, Sm-Ca biofilms exhibited an acidic environment regardless of their hyphal formation ability. Our data reveal the critical role of symbiotic interaction between S. mutans and C. albicans in human saliva in the context of pathogenesis of dental caries, which may explain how the cross-kingdom interaction contributes to enhanced virulence of plaque-biofilm in the oral cavity.

Physicomechanical, optical, and antifungal properties of polymethyl methacrylate modified with metal methacrylate monomers

STATEMENT OF PROBLEM

The high recurrence rates of denture stomatitis may be associated with the resistance of biofilms to therapeutics. Therefore, methods that provide biomaterials with antifungal properties are an attractive solution to improving microbial control.

PURPOSE

The purpose of this in vitro study was to modify conventional polymethyl methacrylate (PMMA) through the incorporation of metal methacrylate monomers and to evaluate the physicomechanical and optical properties and antifungal activity of the modified materials.

MATERIAL AND METHODS

Experimental denture base acrylic resins were fabricated through the addition of zirconium methacrylate (ZM), tin methacrylate (TM), and di-n-butyldimethacrylate-tin (DNBMT) to the liquid of a commercially available denture base PMMA resin. Unmodified PMMA resin was used as the control. The degree of conversion of the materials was tested through Fourier transform infrared spectroscopy (n=3). A digital spectrophotometer was used to assess the color change of the modified materials (n=8). Differences in Knoop hardness and roughness between experimental groups were also evaluated (n=8). A biofilm accumulation test with Candida albicans (ATCC 62342) (n=4) was performed for 5 days in Sabouraud broth culture supplemented with 10% sucrose. Data were subjected to analysis of variance and the post hoc Tukey honestly significant difference test (α=.05).

RESULTS

The degree of conversion and color-change values of the experimental materials were statistically similar to those of the control (P=.593). The incorporation of DNBMT significantly increased the hardness of the modified material (P=.014). The ZM, TM, and DNBMT groups had higher antifungal activity against C. albicans (P=.001) and lower roughness than the control group (control 0.65 ±0.05 μm; ZM 0.34 ±0.09 μm, TM 0.34 ±0.11 μm, and DNBMT 0.41 ±0.08 μm).

CONCLUSIONS

The metal-containing methacrylate monomers provided antifungal action to the modified materials without affecting the physicomechanical or optical properties of the denture base resin. ZM, TM, and DNBMT are potential reactive agents for the fabrication of PMMA denture base resins with antifungal properties.

The Antibacterial Effects of Resin-Based Dental Sealants: A Systematic Review of In Vitro Studies

This review aimed to assess the antimicrobial effects of different antibacterial agents/compounds incorporated in resin-based dental sealants. Four databases (PubMed, MEDLINE, Web of Science and Scopus) were searched. From the 8052 records retrieved, 275 records were considered eligible for full-text screening. Nineteen studies met the inclusion criteria. Data extraction and quality assessment was performed by two independent reviewers. Six of the nineteen included studies were judged to have low risk of bias, and the rest had medium risk of bias. Compounds and particles such as zinc, tin, Selenium, chitosan, chlorhexidine, fluoride and methyl methacrylate were found to be effective in reducing the colony-forming unit counts, producing inhibition zones, reducing the optical density, reducing the metabolic activities, reducing the lactic acid and polysaccharide production and neutralizing the pH when they are added to the resin-based dental sealants. In addition, some studies showed that the antibacterial effect was not significantly different after 2 weeks, 2 months and 6 months aging in distilled water or phosphate-buffered saline. In conclusion, studies have confirmed the effectiveness of adding antibacterial agents/compounds to dental sealants. However, we should consider that these results are based on laboratory studies with a high degree of heterogeneity.

Resin-Based Sealant with Bioactive Glass and Zwitterionic Material for Remineralisation and Multi-Species Biofilm Inhibition

Since pits and fissures are the areas most commonly affected by caries due to their structural irregularity, bioactive resin-based sealant (RBS) may contribute to the prevention of secondary caries. This study aims to investigate the mechanical, physical, ion-release, enamel remineralisation, and antibacterial capabilities of the novel RBS with bioactive glass (BAG) and 2-methacryloyloxyethyl phosphorylcholine (MPC). For the synthesis, 12.5 wt% BAG and 3 wt% MPC were incorporated into RBS. The contact angle, flexural strength, water sorption, solubility, and viscosity were investigated. The release of multiple ions relating to enamel remineralisation was investigated. Further, the attachments of bovine serum albumin, brain heart infusion broth, and Streptococcus mutans on RBS were studied. Finally, the thickness and biomass of a human saliva-derived microsm biofilm model were analysed before aging, with static immersion aging and with thermocycling aging. In comparison to commercial RBS, BAG+MPC increased the wettability, water sorption, solubility, viscosity, and release of multiple ions, while the flexural strength did not significantly differ. Furthermore, RBS with MPC and BAG+MPC significantly reduced protein and bacteria adhesion and suppressed multi-species biofilm attachment regardless of the existence of aging and its type. The novel RBS has great potential to facilitate enamel remineralisation and suppress biofilm adhesion, which could prevent secondary dental caries.