Profuse diversity and acidogenicity of the candida-biome of deep carious lesions of Severe Early Childhood Caries (S-ECC)

Application of mineral trioxide aggregate pulpotomy in the treatment of early pulpitis of primary molars

OBJECTIVE

To evaluate the effectiveness of mineral trioxide aggregate (MTA) on pulpotomy in primary molars.

METHODS

Two hundred and sixty-three cases (310 teeth) of children with early pulpitis of primary molars admitted between February 2019 to February 2022 were enrolled, and their clinical data were retrospectively analyzed. Of them, 130 cases with 155 teeth treated with root canal treatment were set as the control group (CG) and 133 cases with 155 teeth receiving MTA pulpotomy were set as the observation group (OG). Clinical data such as efficacy evaluation, inflammatory factor levels, postoperative adverse reactions, and quality of life (QoL) were compared.

RESULTS

After surgery, the overall response rate in the OG was statistically higher than that in the CG, while the levels of inflammatory factors in the OG were significantly lower than those in the CG (all P<0.05). Moreover, the total incidence of complications was significantly lower in OG at 3, 6, and 12 months after surgery (P=0.018, P=0.007, P=0.015, respectively). The QoL of the two groups differed insignificantly before surgery; however, after the treatment, the QoL in OG was significantly higher than those in the CG at 3, 6, and 12 months after surgery (P=0.037, P=0.012, P=0.028, respectively). Moreover, the teeth location and treatment method were independent factors of efficacy (P=0.047, P=0.001, respectively).

CONCLUSIONS

MTA pulpotomy outperformed root canal treatment for superior efficacy in children with early pulpitis of primary molars, with a positive effect on improving QoL, and patient prognosis.

Antimicrobial and Anti-Inflammatory Oral Effects of Fermented Lingonberry Juice-A One-Year Prospective Human Intervention Study

OBJECTIVES

 A 1-year prospective human intervention study was performed to examine the anticaries, anti-inflammatory, antiproteolytic, and antimicrobial effects of fermented lingonberry juice (FLJ), used as a mouthwash for a period of 6 months, followed by a 6-month washout period.

MATERIALS AND METHODS

 Twenty-five adults were recruited from private dental clinics in Helsinki and Joensuu (Finland). Standard oral examinations and sample gatherings were performed at base level, 6 months, and 1 year for oral Streptococcus mutans (S. mutans), Candida, and Lactobacilli levels, and active matrix metalloprotease-8 (aMMP-8) levels, and for decayed, missing, filled teeth (DMFT), decayed, missing filled surfaces (DMFS) and decayed surfaces (DS) indexes, and probing pocket depths (PPDs), bleeding on probing (BOP), and visible plaque index (VPI). FLJ was used by the participants once daily for 30 seconds for 6 months. FLJ contains 0.212% (w/v) polyphenols, 3% (w/ v) sugars, and contains no excipients. Ten milliliters of FLJ were equal to 1 dL of lingonberry juice.

STATISTICAL ANALYSIS

 Statistical analyses were performed with nonparametric Friedman's test and pairwise post-hoc analysis with Dunn-Bonferroni test, SPSS (version 27; IBM) and p < 0.05 was considered as statistically significant.

RESULTS

 The levels of S. mutans and Candida counts, DS, BOP, and VPI decreased significantly (p < 0.05) during the FLJ period. Lactobacilli counts increased significantly, while there was also significant difference in aMMP-8 levels, DMFT, and DMFS between the three measurement points. PPDs were not affected.

CONCLUSIONS

 The specially formulated FLJ may have a positive decreasing effect on S. mutans, and Candida counts as well as decrease low-grade inflammation and proteolytic burden in the oral mucosa and periodontal tissues. The beneficial effects to the oral cavity of FLJ mouthwash may be useful among patients with oral diseases, such as dental caries, periodontitis and candidosis.

Dose-Dependent Inhibitory Effect of Probiotic Lactobacillus plantarum on Streptococcus mutans-Candida albicans Cross-Kingdom Microorganisms

Dental caries is one of the most common chronic diseases worldwide. Streptococcus mutans and Candida albicans are two major pathogens associated with dental caries. Several recent studies revealed that Lactobacillus plantarum inhibits S. mutans and C. albicans in biofilms and in a rodent model of dental caries. The aim of this study was to investigate the dose-dependent effect of L. plantarum against S. mutans and C. albicans in a planktonic model that simulated a high-caries-risk clinical condition. Mono-, dual-, and multi-species models were utilized, with five doses of L. plantarum (ranging from 1.0 × 10⁴ to 1.0 × 10⁸ CFU/mL). Real-time PCR was used to assess the expression of the virulence genes of C. albicans and S. mutans and the genes of L. plantarum. Student's t-tests and one-way ANOVA, followed by post hoc tests, were employed to compare the cell viability and gene expression among groups. A dose-dependent inhibition on C. albicans and S. mutans was observed with increased dosages of L. plantarum. L. plantarum at 10⁸ CFU/mL demonstrated the highest antibacterial and antifungal inhibitory effect in the dual- and multi-species models. Specifically, at 20 h, the growth of C. albicans and S. mutans was suppressed by 1.5 and 5 logs, respectively (p < 0.05). The antifungal and antibacterial effects were attenuated in lower doses of L. plantarum (10⁴-10⁷ CFU/mL). The expression of C. albicans HWP1 and ECE 1 genes and S. mutans lacC and lacG genes were significantly downregulated with an added 10⁸ CFU/mL of L. plantarum (p < 0.05). The addition of 10⁸ CFU/mL L. plantarum further inhibited the hyphae or pseudohyphae formation of C. albicans. In summary, L. plantarum demonstrated dose-dependent antifungal and antibacterial effects against C. albicans and S. mutans. L. plantarum emerged as a promising candidate for the creation of novel antimicrobial probiotic products targeting dental caries prevention. Further research is warranted to identify the functional metabolites produced by L. plantarum at different dosages when interacting with C. albicans and S. mutans.

Roles of Streptococcus mutans-Candida albicans interaction in early childhood caries: a literature review

As one of the most common oral diseases in kids, early childhood caries affects the health of children throughout the world. Clinical investigations show the copresence of Candida albicans and Streptococcus mutans in ECC lesions, and mechanistic studies reveal co-existence of C. albicans and S. mutans affects both of their cariogenicity. Clearly a comprehensive understanding of the interkingdom interaction between these two microorganisms has important implications for ECC treatment and prevention. To this end, this review summarizes advances in our understanding of the virulence of both C. albicans and S. mutans. More importantly, the synergistic and antagonistic interactions between these two microbes are discussed.

Role of mutans streptococci, acid tolerant bacteria and oral Candida species in predicting the onset of early childhood caries

Aim

Early childhood caries is the most common chronic infectious disease in children in the United States. This study, which is part of a larger, longitudinal study exploring oral microbiological components of caries development in children, reports on the impact of total mutans streptococci (MS), total acid tolerant bacteria and Candida species on the development of dental caries in a subset of these children. Of particular interest was the relationship between caries development and co-colonization of mutans streptococci and Candida species.

Methods

Children between the ages of 12 and 47 months displaying no evidence of dental caries were recruited for a longitudinal study (n = 130). Twelve age- and gender-matched pairs were selected. In each pair, one child developed caries during the study, and one did not. Whole mouth plaque samples were collected by swab at baseline and every 6 months thereafter for a duration of 18 months and spiral plated for microbial counts (CFU/ml). Cut-offs based on percent of total cultivable flora were designated for all microbial measures. A scoring system designated the Plaque Microbial Index (PMI) was developed for use in statistical analyses to assess potential predictive factors for caries risk assessment.

Results

Children who developed caries were significantly more likely to harbor higher percentages of acid tolerant bacteria (p = 0.003), MS (p < 0.001) and have Candida species present (p < 0.001) at ≥1 visit leading up to caries onset. Mean PMI scores derived from the aforementioned microbial measures, were higher for caries active children than caries free children (p = 0.000147). Co-colonization of MS and Candida species was significantly associated with caries development (p < 0.001) and detection of both at the same visit had a 100% positive predictive value and 60% negative predictive value for caries development.

Conclusion

In children who developed caries, there was a statistically significant association with the percent of total flora that was acid tolerant, the percent of MS, the presence of Candida and co-colonization of MS and Candida species. Combining these microbial measures into PMI scores further delineated children who developed caries from those who remained caries-free. These microbiological measures show potential as predictive factors and risk assessment tools for caries development.

Cross-kingdom interaction between Candida albicans and oral bacteria

Candida albicans is a symbiotic fungus that commonly colonizes on oral mucosal surfaces and mainly affects immuno-compromised individuals. Polymicrobial interactions between C. albicans and oral microbes influence the cellular and biochemical composition of the biofilm, contributing to change clinically relevant outcomes of biofilm-related oral diseases, such as pathogenesis, virulence, and drug-resistance. Notably, the symbiotic relationships between C. albicans and oral bacteria have been well-documented in dental caries, oral mucositis, endodontic and periodontal diseases, implant-related infections, and oral cancer. C. albicans interacts with co-existing oral bacteria through physical attachment, extracellular signals, and metabolic cross-feeding. This review discusses the bacterial-fungal interactions between C. albicans and different oral bacteria, with a particular focus on the underlying mechanism and its relevance to the development and clinical management of oral diseases.

Candida albicans and Early Childhood Caries

Early childhood caries (ECC) is a highly prevalent and costly chronic oral infectious disease in preschool children. Candida albicans has been frequently detected in children and has demonstrated cariogenic traits. However, since ECC is a multifactorial infectious disease with many predisposing non-microbial factors, it remains to be elucidated whether the presence and accumulation of C. albicans in ECC is merely a consequence of the adaptation of C. albicans to a cariogenic oral environment, or it plays an active role in the initiation and progression of dental caries. This review aims to summarize the current knowledge on C. albicans and the risk of ECC, with a focus on its synergistic relationship with the cariogenic pathogen Streptococcus mutans. We also highlight recent advances in the development of approaches to disrupt C. albicans-S. mutans cross-kingdom biofilms in ECC prevention and treatment. Longitudinal clinical studies, including interventional clinical trials targeting C. albicans, are necessary to ascertain if C. albicans indeed contributes in a significant manner to the initiation and progression of ECC. In addition, further work is needed to understand the influence of other bacteria and fungi of oral microbiota on C. albicans-S. mutans interactions in ECC.

Diversity of site-specific microbes of occlusal and proximal lesions in severe- early childhood caries (S-ECC)

Background

Severe-early childhood caries (S-ECC) a global problem of significant concern, commonly manifest on the occlusal, and proximal surfaces of affected teeth. Despite the major ecological differences between these two niches the compositional differences, if any, in the microbiota of such lesions is unknown.

Methods

Deep-dentine caries samples from asymptomatic primary molars of children with S-ECC (n 19) belonging to caries-code 5/6, (ICDAS classification) were evaluated. Employing two primer pools, we amplified and compared the bacterial 16S rRNA gene sequences of the seven hypervariable regions (V2—V4 and V6—V9) using NGS-based assay.

Results

Bray-Curtisevaluation indicated that occlusal lesions (OL) had a more homogeneous community than the proximal lesions (PL) with significant compositional differences at the species level (p = 0.01; R- 0.513). Together, the occlusal and proximal niches harbored 263 species, of which 202 (76.8%) species were common to both , while 49 (18.6%) and 12 (4.6%) disparate species were exclusively isolated from the proximal and occlusal niches, respectively. The most commonl genera at both niches included Streptococcus, Prevotella, and Lactobacillus. S. mutans was predominant in PL (p ≤ 0.05), and Atopobium parvulum (p = 0.01) was predominant in OL.

Conclusions

Distinct differences exist between the caries microbiota of occlusal and proximal caries in S-ECC.