Enzymes in the acquired enamel pellicle

Immunorecognition of Streptococcus mutans secreted proteins protects against caries by limiting tooth adhesion

INTRODUCTION

Childhood caries, a prevalent chronic disease, affects 60-90 % of children in industrialized regions, leading to lesions in both primary and permanent teeth. This condition precipitates hospital admissions, emergency room visits, elevated treatment costs, and missed school days, thereby impeding the child's academic engagement and increasing the likelihood of caries into adulthood. Despite multiple identified risk factors, significant interpersonal variability remains unexplained. The immune system generates a unique antibody repertoire, essential for maintaining a balanced and healthy oral microbiome. Streptococcus mutans is a primary contributor to the development of caries.

METHODS

Employing mass spectrometry, we investigated the S. mutans proteins targeted by antibodies in children both with and without caries, delineating a fundamental suite of proteins discernible by the immune systems of a majority of individuals. Notably, this suite was enriched with proteins pivotal for bacterial adhesion. To ascertain the physiological implications of these discoveries, we evaluated the efficacy of saliva in thwarting S. mutans adherence to dental surfaces.

RESULTS

Antibodies in most children recognized a core set of ten S. mutans proteins, with additional proteins identified in some individuals. There was no significant difference in the proteins identified by children with or without caries, but there was variation in antibody binding intensity to some proteins. Functionally, saliva from caries-free individuals, but not children with caries, was found to hinder the binding of S. mutans to teeth. These findings delineate the S. mutans proteome targeted by the immune system and suggest that the inhibition of bacterial adherence to teeth is a primary mechanism employed by the immune system to maintain oral balance and prevent caries formation.

CONCLUSIONS

These findings enhance our knowledge of the immune system's function in oral health maintenance and caries prevention, shedding light on how immunoglobulins interact with S. mutans proteins.

CLINICAL SIGNIFICANCE

Targeting S. mutans proteins implicated in bacterial adhesion could be a promising strategy for preventing childhood caries.

Metabolomics analysis in saliva from periodontally healthy, gingivitis and periodontitis patients

OBJECTIVE

The aim of this study was to investigate metabolomics markers in the saliva of patients with periodontal health, gingivitis and periodontitis.

BACKGROUND

The use of metabolomics for diagnosing and monitoring periodontitis is promising. Although several metabolites have been reported to be altered by inflammation, few studies have examined metabolomics in saliva collected from patients with different periodontal phenotypes.

METHODS

Saliva samples collected from a total of 63 patients were analysed by nuclear magnetic resonance (NMR) followed by ELISA for interleukin (IL)-1β. The patient sample, well-characterised clinically, included periodontal health (n = 8), gingivitis (n = 19) and periodontitis (n = 36) cases, all non-smokers and not diabetic.

RESULTS

Periodontal diagnosis (healthy/gingivitis/periodontitis) was not associated with any salivary metabolites in this exploratory study. Periodontal staging showed nominal associations with acetoin (p = .030) and citrulline (p = .047). Among other investigated variables, the use of systemic antibiotics in the previous 3 months was associated with higher values of the amino acids taurine, glycine and ornithine (p = .002, p = .05 and p = .005, respectively, at linear regression adjusted for age, gender, ethnicity, body mass index and staging).

CONCLUSION

While periodontal staging was marginally associated with some salivary metabolites, other factors such as systemic antibiotic use may have a much more profound effect on the microbial metabolites in saliva. Metabolomics in periodontal disease is still an underresearched area that requires further observational studies on large cohorts of patients, aiming to obtain data to be used for clinical translation.

Sensors for in situ monitoring of oral and dental health parameters in saliva

OBJECTIVES

The oral cavity is an easily accessible unique environment and open system which is influenced by the oral fluids, microbiota, and nutrition. Little is known about the kinetics and dynamics of metabolic processes at the intraoral surfaces. Real-time monitoring of salivary biomarkers, e.g., glucose, lactate, fluoride, calcium, phosphate, and pH with intraoral sensors is therefore of major interest. The aim of this review is to overview the existing literature for intraoral saliva sensors.

MATERIALS AND METHODS

A comprehensive literature search was performed to review the most relevant studies on intraoral saliva sensor technology.

RESULTS

There is limited literature about the in situ saliva monitoring of salivary biomarkers. Bioadhesion and biofouling processes at the intraoral surfaces limit the performances of the sensors. Real-time, long-term, and continuous intraoral measurement of salivary metabolites remains challenging and needs further investigation as only few well-functioning sensors have been developed until today. Until now, there is no sensor that measures reliably beyond hours for any analyte other than glucose.

CONCLUSIONS

Saliva's complex and dynamic structure as well as bioadhesion are key challenges and should be addressed in the future developments. Consequently, more studies that focus particularly on biofouling processes and interferential effects of the salivary matrix components on sensor surfaces are required.

CLINICAL RELEVANCE

By monitoring fluids in the oral cavity, as the entrance to the digestive system, extensive information can be obtained regarding the effects of foods and preventive agents on the oral microbiota and the tooth surfaces. This may lead to a better understanding of strategies to modulate oral and general health.

Enhancement of Antimicrobial Effect of Endodontic Sealers Using Nanoparticles: A Systematic Review

INTRODUCTION

The elimination of biofilms during root canal therapy continues to pose a challenge due to complex anatomies and uninstrumented portions of the root canal system. The incorporation of nanoparticles in endodontic sealers is an area of interest for potentially enhancing antimicrobial activity and improving treatment outcomes. This systematic review evaluated the antimicrobial effects of various nanoparticles in endodontic sealers.

METHODS

Comprehensive literature review was conducted using the electronic Embase, Web of Science, and PubMed databases followed by citation searching for articles eligible per the inclusion criteria.

RESULTS

A total of 1845 citations were screened, of which 13 articles met the inclusion criteria and were included in this review. All included articles were in vitro studies with low-to-moderate quality assessment scores. The incorporation of select nanoparticles was associated with significant enhancement of antibacterial effects in planktonic and/or biofilm forms, whereas other nanoparticles were not.

CONCLUSIONS

The incorporation of certain types and concentrations of nanoparticles into endodontic sealers displayed antimicrobial effects in vitro. The need for well-designed clinical studies translating in vitro findings into clinical practice is warranted. The incorporation of nanoparticles may enhance the antimicrobial properties of endodontic sealers and may improve treatment outcomes.

Salivary Pellicle Formed on Dental Composites Evaluated by Mass Spectrometry-An In Situ Study

(1) Background: In the oral environment, sound enamel and dental restorative materials are immediately covered by a pellicle layer, which enables bacteria to attach. For the development of new materials with repellent surface functions, information on the formation and maturation of salivary pellicles is crucial. Therefore, the present in situ study aimed to investigate the proteomic profile of salivary pellicles formed on different dental composites. (2) Methods: Light-cured composite and bovine enamel samples (controls) were exposed to the oral cavity for 30, 90, and 120 min. All samples were subjected to optical and mechanical profilometry, as well as SEM surface evaluation. Acquired pellicles and unstimulated whole saliva samples were analyzed by SELDI-TOF-MS. The significance was determined by the generalized estimation equation and the post-hoc bonferroni adjustment. (3) Results: SEM revealed the formation of homogeneous pellicles on all test and control surfaces. Profilometry showed that composite surfaces tend to be of higher roughness compared to enamel. SELDI-TOF-MS detected up to 102 different proteins in the saliva samples and up to 46 proteins in the pellicle. Significant differences among 14 pellicle proteins were found between the composite materials and the controls. (4) Conclusions: Pellicle formation was material- and time-dependent. Proteins differed among the composites and to the control.

Dental evaluation is helpful in the differentiation of functional heartburn and gastroesophageal reflux disease

BACKGROUND

Heartburn is identically the key symptom of both, gastroesophageal reflux disease (GERD) and functional heartburn (FHB), making the differential diagnosis resource-intensive. Oral manifestations of GERD can be easily examined; therefore, their exploration might be a cheap, widely available, and useful tool in the differentiation of GERD and FHB.

AIM

To evaluate the prevalence of dental erosions (DE) and periodontal diseases (PD) in patients with heartburn and their association with GERD and FHB.

METHODS

A total of 116 [M/F: 51/65, mean age: 54 (17-80) years] consecutive patients with heartburn were enrolled for detailed esophageal function and orodental examinations.

RESULTS

Dental disorders were detected in 89% (103/116). Patients with PD + DE had significantly more often pathologic reflux (90.0% vs 27.8%; P < 0.05), higher esophagitis scores (1.8 vs 0.9; P < 0.05), and a significantly different mean impedance curve (P = 0.04) than those without any dental diseases. The opposite approach established that patients with GERD had significantly higher prevalence of DE and PD, especially if both were present (28.9% vs 2.0%; P < 0.01), more severe PD (1.5 vs 1.0; P < 0.01), and longer history of heartburn (15 years vs 9 years; P < 0.01) than those with FHB.

CONCLUSION

The dental evaluation of patients with heartburn seems to be useful in the differential diagnosis of GERD and FHB. Among the studied parameters, the co-appearance of DE and PD seems to be the best predictor of GERD, whereas the absence of dental disorders was mostly observed in FHB.

The Post-Translational Modifications of Human Salivary Peptides and Proteins Evidenced by Top-Down Platforms

In this review, we extensively describe the main post-translational modifications that give rise to the multiple proteoforms characterized to date in the human salivary proteome and their potential role. Most of the data reported were obtained by our group in over twenty-five years of research carried out on human saliva mainly by applying a top-down strategy. In the beginning, we describe the products generated by proteolytic cleavages, which can occur before and after secretion. In this section, the most relevant families of salivary proteins are also described. Next, we report the current information concerning the human salivary phospho-proteome and the limited news available on sulfo-proteomes. Three sections are dedicated to the description of glycation and enzymatic glycosylation. Citrullination and N- and C-terminal post-translational modifications (PTMs) and miscellaneous other modifications are described in the last two sections. Results highlighting the variation in the level of some proteoforms in local or systemic pathologies are also reviewed throughout the sections of the manuscript to underline the impact and relevance of this information for the development of new diagnostic biomarkers useful in clinical practice.

The abundance of lysozyme, lactoferrin and cystatin S in the enamel pellicle of children - Potential biomarkers for caries?

OBJECTIVE

In this study, the abundance of the protective salivary proteins lysozyme, lactoferrin, and cystatin S was quantified in the in situ formed pellicle of caries-free and caries-active children to determine whether they may be possible biomarkers for caries.

DESIGN

Pellicle formation was performed in situ for 10 min on ceramic specimens from the oral cavity of children (5-8 years) with caries (n = 17) and without evidence of caries (n = 17). Additionally, unstimulated saliva was collected. Levels of lysozyme, lactoferrin, and cystatin S were measured in desorbed pellicle eluates and saliva using ELISA.

RESULTS

No statistically significant differences were found in the occurrence of cystatin S and lysozyme in saliva and pellicle between caries-active and caries-free children. However, significantly higher amounts of lactoferrin were detected in the pellicle of caries-active children.

CONCLUSION

The protective salivary protein lactoferrin may be a biomarker for caries susceptibility in children.

Biodentine Inhibits the Initial Microbial Adhesion of Oral Microbiota In Vivo

This study aimed to evaluate the in vivo initial microbial adhesion of oral microorganisms on the biomaterial Biodentine compared to MTA and AH Plus. Cylindrical samples of the materials were prepared, and dentin slabs served as a control. An individual intraoral lower jaw splint served as a carrier for the samples and was worn by six volunteers. The specimens were worn for 120 min. Adherent bacteria were quantified by determining the colony-forming units (CFUs), while the visualization and quantification of total adherent microorganisms were facilitated by using DAPI and live/dead staining combined with fluorescence microscopy. Bovine dentin had a significantly higher number of aerobic CFUs compared to Biodentine (p = 0.017) and MTA (p = 0.013). The lowest amounts of DAPI-stained adherent microorganisms were quantified for Biodentine (15% ± 9%) and the control (18% ± 9%), while MTA showed the highest counts of initially adherent microorganisms (38% ± 10%). Significant differences were found for MTA and Biodentine (p = 0.004) as well as for MTA and the control (p = 0.021) and for AH Plus and the control (p = 0.025). Biodentine inhibited microbial adherence, thereby yielding an antimicrobial effectivity similar to that of MTA.

Caries Management-The Role of Surface Interactions in De- and Remineralization-Processes

BACKGROUND

Bioadhesion and surface interactions on enamel are of essential relevance for initiation, progression and prevention of caries and erosions. Salivary proteins on and within initial carious and erosive lesions can facilitate or aggravate de- and remineralization. This applies for the pellicle layer, the subsurface pellicle and for proteins within initial carious lesions. Little is known about these proteinaceous structures related to initial caries and erosion. Accordingly, there is a considerable demand for an understanding of the underlying processes occurring at the interface between the tooth surface and the oral cavity in order to develop novel agents that limit and modulate caries and erosion. Objectives and findings: The present paper depicts the current knowledge of the processes occurring at the interface of the tooth surface and the oral fluids. Proteinaceous layers on dental hard tissues can prevent or aggravate demineralization processes, whereas proteins within initial erosive or carious lesions might hinder remineralization considerably and restrict the entry of ions into lesions.

CONCLUSIONS

Despite the fact that organic-inorganic surface interactions are of essential relevance for de- and remineralization processes at the tooth surface, there is limited knowledge on these clinically relevant phenomena. Accordingly, intensive research is necessary to develop new approaches in preventive dentistry.

Impact of Dentistry Materials on Chemical Remineralisation/Infiltration versus Salivary Remineralisation of Enamel-In Vitro Study

The aim of this study is to evaluate salivary remineralisation versus chemical remineralisation/infiltration of enamel, using different dentistry materials. The enamel changes were studied using confocal laser scanning microscopy (CLSM), and the depth of lesions and demineralisation/remineralisation/infiltration percentage were calculated. Additionally, the macro elemental composition of the teeth was performed using atomic absorption spectroscopy (AAS). Two studies were performed: (i) demineralisation of enamel in 3% citric acid and infiltration treatment with infiltration resin (Icon, DMG), remineralisation with Fluor Protector (Ivoclar Vivadent) and artificial saliva pH 8; and (ii) enamel demineralisation in saliva at pH 3 and remineralisation at salivary pH 8. The results showed that, firstly, for the remineralisation of demineralised enamel samples, Fluor Protector (Ivoclar Vivadent) was very effective for medium demineralised lesions followed by saliva remineralisation. In cases of deep demineralisation lesions where fluoride could not penetrate, low viscosity resin (Icon, DMG, Hamburg) effectively infiltrated to stop the demineralisation process. Secondly, remineralisation in salivary conditions needed supplementary study over a longer period, to analyse the habits, diet and nutrition of patients in detail. Finally, demineralisation/remineralisation processes were found to influence the macro elemental composition of enamel demineralisation, with natural saliva proving to be less aggressive in terms of decreasing Ca and Mg content.

The sampling strategy of oral microbiome

There are multiple habitats in the oral cavity with bacteria, fungi, viruses, and protozoa residing in, which together constitute the oral micro-ecosystem. These microflorae in the oral cavity primarily include saliva, supragingival dental plaque, subgingival dental plaque, submucosal plaque around implants, plaque in root canals, and plaque on the mucosal surface. The interest and knowledge of the microbiome have dynamically increased with the advancement of technology. Therefore, a reliable, feasible, and practical sampling strategy for the oral microbiome is required for the investigation. This paper introduced the sampling strategy of oral microorganisms, consisting of sample collection, transport, processing, and storage. The materials and devices involved in this study are all commonly used in clinical practice or laboratory. The feasibility and reliability of the sampling methods described in this paper have been verified by multiple studies.

A Mass Spectrometric Approach to the Proteomic Profiling of the Canis lupus familiaris Acquired Enamel Pellicle on Hydroxyapatite Discs

The acquired enamel pellicle (AEP) is a multi-protein film attached to the surface of teeth, which functions to lubricate the dental surface, form an anti-erosive barrier and exhibits antimicrobial properties. The initiation of AEP formation occurs within seconds of exposure to saliva, a biofluid rich in protein species. While there have been many publications on the formation of human AEP there is little research on the composition of canine AEP during its acquisition. The aim of these studies was to explore the composition of canine AEP formation, utilising hydroxyapatite (HA) discs as a tooth substitute matrix, over time. Qualitative and quantitative proteomics techniques using tandem mass tag labelled peptides and LC-MS/MS were used to follow the formation of canine AEP on hydroxyapatite discs over the course of an hour. Proteins adsorbed to the HA surface included highly abundant proteins in canine saliva, antimicrobial proteins, protease inhibitors and the buffering agent carbonic anhydrase. Greater understanding of the canine AEP deepens fundamental knowledge of the early processes driving bacterial colonisation of the tooth surface and subsequent plaque accumulation.

Colloidal dynamics of emulsion droplets in mouth

The interaction of emulsions with the tongue is key to the sensory appeal of food and can potentially be exploited for oral/buccal pharmaceutical delivery. Whilst there is good understanding of the different mucoadhesive forces governing emulsion interaction with the tongue, their relative importance is not well understood. In addition, the physical location of emulsions within the saliva papillae on the tongue is not understood at all. A combination of ex vivo salivary film, and in vivo oral coating experiments were used to determine the importance of different mucoadhesive forces. Mucoadhesion of cationic emulsions was largely driven by electrostatic complexation. SDS-PAGE of the in vivo saliva coating highlighted that mucins were largely responsible for cationic emulsion mucoadhesion. Anionic emulsions were bound via hydrophobic/steric interactions to small salivary proteins typically located away from the mucin anchor points. The physical location and clustering of emulsions relative to the salivary film/papillae was probed via the invention of a fluorescent oral microscope. Cationic emulsions were densely clustered close to the papillae whilst anionic emulsions were suspended in the salivary film above the papillae. Interestingly, non-ionic emulsions were also trapped within the salivary film above the papillae as individual droplets. These findings highlight that whilst electrostatic complexation with saliva is a powerful mucoadhesive force, hydrophobic and steric interactions also act to induce oral retention of emulsions. The differences in physical location and clustering of emulsions within the salivary film hint at the 3D locations of the different salivary proteins driving each mucoadhesive interaction. This novel understanding of emulsion saliva/papillae interactions has potential to aid efficacy of buccal pharmaceutical delivery and the reduction of astringency in plant-based foods.

Modulation of Streptococcus mutans Adherence to Hydroxyapatite by Engineered Salivary Peptides

Since the modification of the proteinaceous components of the Acquired Enamel Pellicle (AEP) could influence the adhesion of Streptococcus mutans, the most cariogenic bacteria, to dental surfaces, we assessed if engineered salivary peptides would affect the adherence and modulate the bacterial proteome upon adherence. Single-component AEPs were formed onto hydroxyapatite (HAp) discs by incubating them with statherin, histatin-3, DR9, DR9-DR9, DR9-RR14, RR14, and parotid saliva. Then, the discs were inoculated with S. mutans UA159 and the bacteria were allowed to adhere for 2 h, 4 h, and 8 h (n = 12/treatment/time point). The number of bacteria adhered to the HAp discs was determined at each time point and analyzed by two-way ANOVA and Bonferroni tests. Cell-wall proteins were extracted from adhered, planktonic, and inoculum (baseline) bacteria and proteome profiles were obtained after a bottom-up proteomics approach. The number of adhered bacteria significantly increased over time, being the mean values obtained at 8 h, from highest to lowest, as follows: DR9-RR14 > statherin > RR14 = DR9-DR9 > DR9 = histatin3 > saliva (p < 0.05). Treatments modulated the bacterial proteome upon adherence. The findings suggested a potential use of our engineered peptide DR9-DR9 to control S. mutans biofilm development by reducing bacterial colonization.

Defect Induced Charge Redistribution and Enhanced Adsorption of Lysozyme on Hydroxyapatite for Efficient Antibacterial Activity

Defects in hydroxyapatite (HA) have attracted increasing research interest due to their significant functions to increase the bioactivity and antibacterial ability of hard-tissue implants. However, little is known about the natural property and functional mechanism of the defects in HA. Herein, we reported on the defect property concerned with the coordination state and charge distribution in Al doped HA, as well as the consequent interface and protein capture ability for improved antibacterial activity. Systemic investigations suggested that Al replacing Ca in HA induced coordination defect with decreased coordination number and bond distance, caused charge transfer and redistribution of surrounding O atom and resulted in an increase in negative charge of coordinated O atoms. These O atoms coordinated with Al further served as docking sites for lysozyme molecules via electrostatic and H-bonding interaction. The capacity of lysozyme adsorption for Al-HA increased approximately 10-fold more than that of HA, which significantly increased the antibacterial activity through lysozyme-catalyzed splitting of cell wall of bacteria. Moreover, in vitro studies indicated that Al-HA materials showed good cytocompatibility. These findings not only provided new insights into the important effect of defects on the performances of HA biomaterials by modulation of the coordination state, charge distribution, and chemical activity, but also proposed a promising method for efficient antibacterial activity of HA biomaterials.

The dentin pellicle - A neglected topic in dental research

OBJECTIVE

All soft and solid surfaces exposed to the oral cavity are covered by an acquired pellicle. While the pellicle adsorbed on enamel is well researched, only limited data are available on the dentin pellicle. The purpose of the present review is to summarize studies considering the composition, structure and properties of the dentin pellicle and compare them with the current state of research on enamel pellicle.

METHODS

The literature search was conducted using Medline database and Google Scholar, including checking reference lists of journal articles by handsearching. Thereby, 19 studies were included in the present review.

RESULTS AND CONCLUSION

The dentin pellicle has a similar ultrastructure to the enamel pellicle, which is up to 1 μm thick depending on pellicle formation time and localization in the oral cavity. In contrast, due to the lack of studies on the dentin pellicle regarding its composition and properties, a comparison to the enamel pellicle is difficult. So far, only one study showed anti-abrasive properties and data on anti-erosive properties were controversial. Despite becoming more and more clinically relevant due to the increasing frequency of dentin exposure, the dentin pellicle is largely unexplored. For further investigations it is not only necessary to standardize dentin specimens, but also to assess fundamental research on dentin itself, as its complex morphology and composition may have a crucial influence on pellicle formation. Furthermore, a more detailed knowledge of the dentin pellicle may also reveal target sites for modification in favor of its protective properties.

Lactobacillus reuteri BM53-1 Produces a Compound That Inhibits Sticky Glucan Synthesis by Streptococcus mutans

Cariogenic bacteria, such as Streptococcus (S.) mutans and S. sobrinus, produce insoluble and sticky glucans as a biofilm material. The present study demonstrates that a lactic acid bacterium (LAB) named BM53-1 produces a substance that inhibits the sticky glucan synthesis. The BM53-1 strain was isolated from a flower of Actinidia polygama and identified as Lactobacillus reuteri. The substance that inhibits sticky glucan synthesis does not exhibit antibacterial activity against S. mutans. The cariogenic S. mutans produces glucans under the control of three glucosyltransferase (GTF) enzymes, named GtfB, GtfC, and GtfD. Although GtfB and GtfC produce insoluble glucans, GtfD forms soluble glucans. Through quantitative reverse-transcriptional (qRT)-PCR analysis, it was revealed that the BM53-1-derived glucan-production inhibitor (GI) enhances the transcriptions of gtfB and gtfC genes 2- to 7-fold at the early stage of cultivation. However, that of gtfD was not enhanced in the presence of the GI, indicating that the glucan stickiness produced by S. mutans was significantly weaker in the presence of the GI. Our result demonstrates that Lb. reuteri BM53-1 is useful to prevent dental caries.

Preventive Applications of Polyphenols in Dentistry-A Review

Polyphenols are natural substances that have been shown to provide various health benefits. Antioxidant, anti-inflammatory, and anti-carcinogenic effects have been described. At the same time, they inhibit the actions of bacteria, viruses, and fungi. Thus, studies have also examined their effects within the oral cavity. This review provides an overview on the different polyphenols, and their structure and interactions with the tooth surface and the pellicle. In particular, the effects of various tea polyphenols on bioadhesion and erosion have been reviewed. The current research confirms that polyphenols can reduce the growth of cariogenic bacteria. Furthermore, they can decrease the adherence of bacteria to the tooth surface and improve the erosion-protective properties of the acquired enamel pellicle. Tea polyphenols, especially, have the potential to contribute to an oral health-related diet. However, in vitro studies have mainly been conducted. In situ studies and clinical studies need to be extended and supplemented in order to significantly contribute to additive prevention measures in caries prophylaxis.

Proteomic profile of the acquired enamel pellicle of professional wine tasters with erosive tooth wear

The aim of this study was to compare the acquired enamel pellicle protein profile of professional wine tasters with mild and moderate erosive tooth wear. Twelve professional wine tasters participated (3 from a low tooth wear group; 9 from a high tooth wear group). Acquired enamel pellicle samples were collected and processed for proteomic analysis (nLC-ESI-MS/MS). The acquired enamel pellicle proteomic profile was different between the groups. The proteins found exclusively in the low tooth wear group were histatins 1 and 3 and mucins 7 and 21. When comparing the wear groups, proteins with higher levels in the low tooth wear group included neutrophil defensins (1 and 3), lysozyme C, lysozyme, myeloperoxidase, and squalene monooxygenase. In conclusion, the findings indicate that the proteins found at higher levels in the low tooth wear group and proteins exclusively found in the low tooth wear group might be protective and, therefore, could be good candidates for further studies regarding their potential to be added to dental products to protect professional wine tasters from extrinsic erosive tooth wear.

Amylase Alpha 1 Gene (AMY1) Copy Number Variation and Dental Caries Experience: A Pilot Study among Adults in Lithuania

INTRODUCTION

Genetic biomarkers have the potential to be used in personalised dentistry for improved prevention and decision-making in caries management. The amylase alpha 1 gene (AMY1) encodes salivary α-amylase and may be one such biomarker. We examined the association between AMY1 copy number variation (CNV) and dental caries experience in adults.

MATERIALS AND METHODS

A stratified random sample of 193 participants from the Lithuanian National Oral Health Survey (LNOHS) agreed to provide saliva samples and were included in this analysis (age 35-44 years; participation rate 43%). Information on socio-demographic and behavioural characteristics was taken from the LNHOS, which used the self-administered World Health Organisation (WHO) questionnaire. Data on fluoride levels in drinking water at the recruitment areas was recorded based on information provided by water suppliers. Dental caries experience was recorded at a surface level (smooth-surface and occlusal-surface decayed, missing, filled surfaces [D3MFS] score) by one trained and calibrated examiner using WHO criteria, and subsequently dichotomised for the statistical analyses. DNA extracted from saliva samples was used to investigate AMY1 CNV using the QX200 droplet digital PCR system. Bivariate and multivariable statistical analyses were employed.

RESULTS

When compared to participants with an AMY1 copy number (CN) of 2-3, higher odds of smooth-surface D3MFS >14 was observed for participants with a CN of 4-5 (OR 13.3, 95% CI 2.1-86.3), 6-9 (OR 7.0, 95% CI 1.4-34.1), and 10-16 (OR 5.8, 95% CI 1.2-32.2). Female sex was independently associated with a smooth-surface D3MFS >14 (OR 5.7, 95% CI 1.9-17.2).

CONCLUSIONS

Our study demonstrated an association between AMY1 CNV and high smooth-surface caries experience. Studies with larger sample sizes are needed to validate this association.

Evaluation of Anti-Biofilm Activity of Mouthrinses Containing Tannic Acid or Chitosan on Dentin In Situ

In contrast to enamel, dentin surfaces have been rarely used as substrates for studies evaluating the effects of experimental rinsing solutions on oral biofilm formation. The aim of the present in situ study was to investigate the effects of tannic acid and chitosan on 48-h biofilm formation on dentin surfaces. Biofilm was formed intraorally on dentin specimens, while six subjects rinsed with experimental solutions containing tannic acid, chitosan and water as negative or chlorhexidine as positive control. After 48 h of biofilm formation, specimens were evaluated for biofilm coverage and for viability of bacteria by fluorescence and scanning electron microscopy. In addition, saliva samples were collected after rinsing and analyzed by fluorescence (five subjects) and transmission electron microscopy (two subjects) in order to investigate the antibacterial effect on bacteria in a planktonic state and to visualize effects of the rinsing agents on salivary proteins. After rinsing with water, dentin specimens were covered by a multiple-layered biofilm with predominantly vital bacteria. In contrast, chlorhexidine led to dentin surfaces covered only by few and avital bacteria. By rinsing with tannic acid both strong anti-adherent and antibacterial effects were observed, but the effects declined in a time-dependent manner. Transmission electron micrographs of salivary samples indicated that aggregation of proteins and bacteria might explain the antiadhesion effects of tannic acid. Chitosan showed antibacterial effects on bacteria in saliva, while biofilm viability was only slightly reduced and no effects on bacterial adherence on dentin were observed, despite proteins being aggregated in saliva after rinsing with chitosan. Tannic acid is a promising anti-biofilm agent even on dentin surfaces, while rinsing with chitosan could not sufficiently prevent biofilm formation on dentin.

In-vitro Evaluation of toothpaste containing enzymes and proteins on inhibiting plaque re-growth of the children with high caries experience

Background

Dental caries belong to a disease which has a complex etiology. Individual preventive measures are not adequate enough to control the disease especially in children with high caries experience The aim of the study was to evaluate the efficacy of tooth paste containing enzymes and proteins in inhibiting plaque re-growth when compared to fluoride tooth paste in children with high caries experience.

Material and Methods

A total of 15 plaque samples are collected from 15 subjects in the age group of 5-7 years with High caries experience. The participants were asked to fast overnight for 12 h. On the day of the study, the participants were asked to report without brushing. Pre brushing pooled plaque was collected from buccal and palatal/lingual surfaces of maxillary and mandibular teeth and transferred to chilled Eppendorf tubes. Samples were divided into two groups; according to the test toothpaste used; Zendium toothpaste and Colgate cavity protection along with controls. Inhibition of plaque re-growth is assessed by comparing optical density using a spectrophotometer at intervals between 0-8 hours.

Results

Results demonstrated that toothpaste containing enzymes and proteins can significantly inhibit plaque growth when compared to normal toothpaste (p<0.05) in children with high caries experience.

Conclusions

Toothpaste containing enzymes and proteins can augment natural salivary defenses and control plaque re-growth which plays a major role in dental caries formation.

Key words:Enzymes, proteins, toothpaste, children, caries, dental plaque.

Functional Specialization of Human Salivary Glands and Origins of Proteins Intrinsic to Human Saliva

Salivary proteins are essential for maintaining health in the oral cavity and proximal digestive tract, and they serve as potential diagnostic markers for monitoring human health and disease. However, their precise organ origins remain unclear. Through transcriptomic analysis of major adult and fetal salivary glands and integration with the saliva proteome, the blood plasma proteome, and transcriptomes of 28+ organs, we link human saliva proteins to their source, identify salivary-gland-specific genes, and uncover fetal- and adult-specific gene repertoires. Our results also provide insights into the degree of gene retention during gland maturation and suggest that functional diversity among adult gland types is driven by specific dosage combinations of hundreds of transcriptional regulators rather than by a few gland-specific factors. Finally, we demonstrate the heterogeneity of the human acinar cell lineage. Our results pave the way for future investigations into glandular biology and pathology, as well as saliva's use as a diagnostic fluid.

Salivary Hemoglobin Protects against Erosive Tooth Wear in Gastric Reflux Patients

<b><i>Objective:</i></b> Saliva is the most important biological factor to protect against erosive tooth wear (ETW). Gastroesophageal reflux disease (GERD) patients have an increased risk of ETW due to the frequent presence of intrinsic acids in the oral cavity. Remarkably, not all GERD patients suffer from ETW, which might be due to differences in the composition of the saliva. <b><i>Methods:</i></b> This study compared the proteomic profile of saliva in patients (1) with GERD and ETW (basic erosive wear examination, BEWE, score ≥9; GE group) and (2) with GERD without ETW (BEWE = 0; GNE group) using shotgun label-free quantitative proteomic analysis nLC-ESI-MS/MS. The ability of hemoglobin (Hb) to protect against initial enamel erosion caused by a daily 10-s immersion of enamel specimens in 0.01 M HCl (pH 2.3) for 3 days was evaluated in vitro for proof of concept. Surface hardness change was used as response variable. <b><i>Results:</i></b> The differential expression of Hb subunits was significantly increased in the GNE group versus the GE group, in particular the Hb α-subunit that showed a &#x3e;22-fold increase. Expressions of serum albumin (4.5-fold) and isoforms of cytoskeletal keratin type II (&#x3e;3-fold) were also increased in the GNE group. Proteinase inhibitors, such as α₁-antitrypsin and α₂-macroglobulin, were only identified in the GNE group. In vitro, Hb (1.0 and 4.0 mg/mL) significantly reduced initial enamel erosion compared to a negative control after 3 days. <b><i>Conclusions:</i></b> Our results indicate that many proteins, with special emphasis on Hb, may be involved in the resistance of GERD patients to the occurrence of ETW. These proteins may be candidates for inclusion in dental products to protect against ETW.

Comparative evaluation of efficacy of enzymatic toothpaste over standard fluoridated toothpaste in reduction of plaque and gingivitis

OBJECTIVES

To compare and evaluate the efficacy of enzymatic toothpaste v/s standard fluoridated toothpaste in reduction of plaque and gingivitis during maintenance phase after non-surgical periodontal therapy (NSPT).

MATERIALS AND METHODS

A total of 52 participants belonging to age 20-50 years eligible for inclusion were randomly chosen from the outpatient department. Computer-generated randomization was followed to recruit the subjects into two groups. 26 subjects were assigned to control group who were given with control toothpaste (standard fluoridated toothpaste), while 26 subjects were assigned to test group (enzymatic toothpaste) and given with test toothpaste. The amount of dental plaque and gingivitis were assessed baseline visit and at 6-week follow-up visit using Turesky-Gilmore-Glickman modification of the Quigley-Hein plaque index (TQHPI) 1970, Gingival Index (GI) - (Löe and Sillness 1963) and Full Mouth Bleeding Score (FMBS), respectively. Data analysis was done using IBM SPSS^® version 22.

RESULTS

Intergroup comparison of TQHPI, GI and FMBS among test and control group has shown that test group had statistically significant lower values than the control group at the follow-up visit. (p = 0.006*, p = 0.001*, p = 0.001*, respectively).

CONCLUSIONS

Within the limitations of our study, it can be concluded that test toothpaste has shown to be efficient than the previously set standard control fluoridated toothpaste in terms of reduction of plaque and gingivitis during maintenance phase after non-surgical periodontal therapy (NSPT).

Effect of fragaria vesca, hamamelis and tormentil on the initial bacterial colonization in situ

OBJECTIVE

The presentin situ study aims to examine the influence of the polyphenolic tea drugs fragaria vesca, hamamelis and tormentil on the initial oral bioadhesion.

DESIGN

Initial biofilm formation was performed on bovine enamel slabs which were carried intraorally by 12 subjects. After 1 min of intraoral pellicle formation, the subjects rinsed with fragaria vesca, tormentil (0.8 mg/8 mL) and hamamelis (0.2 mg/8 mL) for 10 min. Tap water served as negative control, 0.2 % CHX as positive control. The investigations took place on different days (wash-out: 2 days). Afterwards, fluorescence microscopy has been performed per test solution (n = 5) and per subject (n = 12) to visualize bacterial adhesion and glucan formation (8 h oral exposition) with DAPI, ConA and BacLight. Additionally, TEM was used to visualize the pellicle ultrastructure and expectorate samples. Statistical evaluation was carried out using the Kruskal-Wallis- (p < 0.5), Mann-Whitney U test (p < 0.5) and Bonferroni-Holm-correction (p < 0.1).

RESULTS

Rinsing with the polyphenolic tea extracts reduced significantly initial bacterial colonization (DAPI) compared to the negative control. There was no significant difference betweenfragaria vesca, hamamelis and tormentil. All solutions showed a reducing effect on the glucan formation. No significant difference was observed between fragaria vesca and CHX. Considerable alterations of the pellicle's ultrastructure manifested by an increase in thickness and electron density resulted from rinsing with the three polyphenolic aqueous extracts.

CONCLUSIONS

Fragaria vesca, hamamelis and tormentil significantly reduce initial bioadhesion and glucan formation in situ and are therefore recommended as adjuvant antibacterial oral therapeutics.

Development of novel surface coating composed of MDPB and MPC with dual functionality of antibacterial activity and protein repellency

Resin-based reconstructive/restorative materials with antibacterial effects are potentially useful for preventing dental and oral diseases. To this end, the immobilization of an antibacterial component on the surface of a resin by incorporating polymerizable bactericide such as a quaternary ammonium compound-monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) is an effective technique. However, the effectiveness of immobilized bactericide is reduced by salivary protein coverage. We address this issue by utilizing 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, which exhibits protein repellency, with MDPB to fabricate a novel copolymer, which served as a surface coating on a methacrylate-based resin. This coating provided a more hydrophilic surface than that provided by MDPB coating and reduced the adsorption of bovine serum albumin and salivary protein. To evaluate bacterial growth on the contact surface, Streptococcus mutans suspension was placed on the coated specimen. After 24-h incubation, MDPB/MPC copolymer exhibited killing effects against S. mutans. Moreover, confocal laser scanning microscopy and scanning electron microscopy were used to evaluate biofilm formation after 48-h incubation in S. mutans suspension, which revealed sparse biofilm and dead bacteria in biofilm on the surface coated with MDPB/MPC. Overall, the proposed surface coating on dental resins exhibited protein-repellent ability and inhibitory effects against bacteria and oral biofilms.

Ageing of Dental Composites Based on Methacrylate Resins-A Critical Review of the Causes and Method of Assessment

The paper reviews the environmental factors affecting ageing processes, and the degradation of resins, filler, and the filler-matrix interface. It discusses the current methods of testing materials in vitro. A review of literature was conducted with the main sources being PubMed. ScienceDirect, Mendeley, and Google Scholar were used as other resources. Studies were selected based on relevance, with a preference given to recent research. The ageing process is an inherent element of the use of resin composites in the oral environment, which is very complex and changes dynamically. The hydrolysis of dental resins is accelerated by some substances (enzymes, acids). Bonds formed between coupling agent and inorganic filler are prone to hydrolysis. Methods for prediction of long-term behaviour are not included in composite standards. Given the very complex chemical composition of the oral environment, ageing tests based on water can only provide a limited view of the clinical performance of biomaterial. Systems that can reproduce dynamic changes in stress (thermal cycling, fatigue tests) are better able to mimic clinical conditions and could be extremely valuable in predicting dental composite clinical performance. It is essential to identify procedure to determine the ageing process of dental materials.

Novel Bioactive and Therapeutic Root Canal Sealers with Antibacterial and Remineralization Properties

According to the American Dental Association Survey of Dental Services Rendered (published in 2007), 15 million root canal treatment procedures are performed annually. Endodontic therapy relies mainly on biomechanical preparation, chemical irrigation and intracanal medicaments which play an important role in eliminating bacteria in the root canal. Furthermore, adequate obturation is essential to confine any residual bacteria within the root canal and deprive them of nutrients. However, numerous studies have shown that complete elimination of bacteria is not achieved due to the complex anatomy of the root canal system. There are several conventional antibiotic materials available in the market for endodontic use. However, the majority of these antibiotics and antiseptics provide short-term antibacterial effects, and they impose a risk of developing antibacterial resistance. The root canal is a dynamic environment, and antibacterial and antibiofilm materials with long-term effects and nonspecific mechanisms of action are highly desirable in such environments. In addition, the application of acidic solutions to the root canal wall can alter the dentin structure, resulting in a weaker and more brittle dentin. Root canal sealers with bioactive properties come in direct contact with the dentin wall and can play a positive role in bacterial elimination and strengthening of the root structure. The new generation of nanostructured, bioactive, antibacterial and remineralizing additives into polymeric resin-based root canal sealers are discussed in this review. The effects of these novel bioactive additives on the physical and sealing properties, as well as their biocompatibility, are all important factors that are presented in this article.

Targeted metabolomics of pellicle and saliva in children with different caries activity

Pellicle is the initial proteinaceous layer that is formed almost instantaneously on all solid surfaces in the oral cavity. It is of essential relevance for any interactions and metabolism on the tooth surface. Up to now, there is no information on the metabolome of this structure. Accordingly, the present study aims to characterise the metabolomic profile of in-situ pellicle in children with different caries activity for the first time in comparison to saliva. Small molecules such as carbohydrates, amino acids, organic acids, and fatty acids, putatively involved in the formation of caries were quantified using mass spectrometry (MS)-based techniques, such as (stable isotope dilution analysis)-ultra-performance liquid chromatography-tandem MS and gas chromatography/electron ionisation-MS. Pellicle and corresponding saliva samples were collected from caries-active, caries-free and caries-rehabilitated 4- to 6-year-old children. The most abundant analytes in pellicle were acetic acid (1.2-10.5 nmol/cm2), propionic acid (0.1-8.5 nmol/cm2), glycine (0.7-3.5 nmol/cm2), serine (0.08-2.3 nmol/cm2), galactose (galactose + mannose; 0.035-0.078 nmol/cm2), lactose (0.002-0.086 nmol/cm2), glucose (0.018-0.953 nmol/cm2), palmitic acid (0.26-2.03 nmol/cm2), and stearic acid (0.34-1.81 nmol/cm2). Significant differences depending on caries activity were detected neither in saliva nor in the corresponding pellicle samples.

Mapping of Transglutaminase-2 Sites of Human Salivary Small Basic Proline-Rich Proteins by HPLC-High-Resolution ESI-MS/MS

Because of the distinctive features of the oral cavity, the determination of the proteins involved in the formation of the "oral protein pellicle" is demanding. The present study investigated the susceptibility of several human basic proline-rich peptides, named P-H, P-D, P-F, P-J, and II-2, as substrates of transglutaminase-2. The reactivity of the P-C peptide and statherin was also investigated. Peptides purified from human whole saliva were incubated with the enzyme in the presence or in the absence of monodansyl-cadaverine. Mass spectrometry analyses of the reaction products highlighted that P-H and P-D (P₃₂ and A₃₂ variants) were active substrates, II-2 was less reactive, and P-F and P-J showed very low reactivity. P-C and statherin were highly reactive. All of the peptides formed cyclo derivatives, and only specific glutamine residues were involved in the cycle formation and reacted with monodansyl-cadaverine: Q₂₉ of P-H, Q₃₇ of P-D, Q₂₁ of II-2, Q₄₁ of P-C, and Q₃₇ of statherin were the principal reactive residues. One or two secondary glutamine residues of only P-H, P-D P₃₂, P-C, and statherin were hierarchically susceptible to the reaction with monodansyl-cadaverine. MS and MS/MS data were deposited to the ProteomeXchange Consortium ( http://www.ebi.ac.uk/pride ) via the PRIDE partner repository with the data set identifier PXD014658.

Influence of Electronic Cigarettes on Selected Antibacterial Properties of Saliva

The aim of this study was to estimate changes in selected physicochemical properties of saliva collected from users of electronic cigarettes. Methods: The study population consisted of 120 patients (40 users of electronic cigarettes, 40 smokers of traditional cigarettes and 40 non-smokers). Laboratory tests included verification of saliva amount of lysozyme, lactoferrin and IgA. Results: Among e-cigarette users, statistically significant differences were observed in values of lysozyme and lactoferrin; however, no statistically significant differences for the IgA value were found. In the group of traditional cigarette smokers, statistically significant differences were observed among all tested parameters in relation to the control group. In relation to IgA, statistically significant differences were found between e-cigarette users and traditional cigarette smokers, to the disadvantage of the latter. Conclusion: Saliva of e-cigarette users showed changes of antibacterial properties in comparison to the control group and traditional cigarette smokers. Further longitudinal studies on larger study groups should be conducted in order to assess the effect of observed changes in the antibacterial properties of saliva on oral health.

Characteristics of adhesive bonding with enamel deproteinization

OBJECTIVE

To evaluate the effect of using sodium hypochlorite (NaOCl) on the bond characteristics of orthodontic metal brackets bonded to enamel surface using three adhesive systems.

METHODS

One hundred twenty premolars were selected and randomly divided into two equal groups of 60 teeth/ each (Groups I and II). The teeth of Group I were left untreated while those of Group II were exposed to 5.25% NaOCl for 1 minute. The teeth in either group were randomly subdivided into three equal subgroups of 20 teeth/ each (A, B and C), according to the type of adhesive system used to bond the brackets. In Subgroup A, phosphoric acid + Transbond XT primer and adhesive were used. In subgroup B, Transbond Plus self-etching primer (SEP) + Transbond XT adhesive were utilized. In subgroup C, phosphoric acid + SmartBond LC adhesive were used. The shear bond strength (SBS) and the degree of adhesive penetration to enamel surface were assessed. Data analyses were performed using ANOVA, post-hoc (LSD), t and chi-square test.

RESULTS

Transbond XT had significantly higher SBS than SmartBond LC (p< 0.05). Phosphoric acid provided significantly higher SBS and degree of adhesive penetration than SEP (p< 0.05). NaOCl significantly increased SBS and degree of adhesive penetration in Subgroups B and C (p< 0.05).

CONCLUSION

Adhesion quality of Transbond XT adhesive is better than SmartBond LC. Phosphoric acid is more effective than SEP. NaOCl enhances the bond characteristics.

Activity and distribution pattern of enzymes in the in-situ pellicle of children

OBJECTIVE

This study investigated, for the first time, pellicle enzymes with respect to their activity, distribution and fluorescence pattern in children with different caries experience.

DESIGN

In-situ pellicles were collected from 41 children (aged 4-6 years) with different caries status; 17 of them were caries-free (dmf = 0), 12 had dental restorations but no current caries (dmf ≥ 2) and 12 had at least two carious lesions (dmf ≥ 2). Bovine enamel samples were fixed on individual upper jaw braces for pellicle formation. After 30 min of intraoral exposure, the pellicle and saliva samples were analysed for the activities of amylase, lysozyme, peroxidase and glucosyltransferase (GTF). The distribution of these enzymes, including GTF-isoforms B, C and D, and the pellicle ultrastructure were examined by gold-immunolabelling and transmission electron microscopy (TEM). Furthermore, interactions between pellicle enzymes and adherent bacteria were visualised using combined fluorescence and immunofluorescence labelling.

RESULTS

There were no significant differences in the pellicle enzyme activities between the study groups. TEM analysis revealed the absence of GTF C and D in the pellicle of caries-active children. Amylase, peroxidase and GTF-isoforms showed a random distribution within the pellicle layer; lysozyme was found in the form of clusters. A similar ultrastructural pattern was observed for all subjects. Fluorescence labelling technique enabled visualisation of all enzymes, except for GTF B.

CONCLUSION

Pellicle enzyme activities and ultrastructure are not associated with children's caries status. Further investigation is needed to assess the influence of individual GTF-isoforms on caries susceptibility in children.

Salivary functions in mastication, taste and textural perception, swallowing and initial digestion

Saliva exerts multiple functions in relation to the initial digestive processes taking place in the upper parts of the gastrointestinal tract. Ingestion of food and beverages, in turn, is a strong stimulus for secretion of saliva with a differential composition depending on the neuronal stimulation pattern. This review paper provides insight into the mechanisms by which saliva acts in relation to taste, mastication, bolus formation, enzymatic digestion and swallowing. Also, the protective functions of saliva including maintenance of dental and mucosal integrity will be discussed as they indirectly influence the digestive process. The final part of this study focuses on the implications of xerostomia and salivary gland dysfunction on gastrointestinal functions.

Influence of Surfactants and Fluoride against Enamel Erosion

This study investigated the effect of surfactants associated with sodium fluoride (NaF) on enamel erosion prevention, using an erosion-remineralization in vitro model. Sodium lauryl sulfate (SLS), polysorbate 20 (P20), and cocoamidopropyl betaine (CAPB) were tested, at concentrations of 1.0 and 1.5%, and associated or not with NaF (275 ppm). The control groups were distilled water and the NaF solution. Bovine enamel samples (n = 12) were prepared and submitted to a 5-day cycling model: acid challenge (0.3% citric acid, pH 2.6, 4×/day), human saliva (2 h, 4×/day), and the treatment solutions (2 min, 2×/day). The protective potential of the agents against initial erosion was assessed by microhardness and the surface loss by profilometry. Enamel surface wettability was determined by goniometry, protein adsorption was measured by spectroscopy (FTIR), and the KOH-soluble fluoride was quantified. Goniometry showed that SLS and CAPB increased enamel wettability. No differences were found among the surfactants regarding protein adsorption. Microhardness showed that SLS reduced NaF protection. P20 (1 and 1.5%) and CAPB 1.5% presented a protective effect, but lower than the NaF solution. Profilometry showed that CAPB protected enamel, but no agent associated with NaF promoted a higher protection than the NaF solution alone. KOH-soluble fluoride analysis showed that all surfactants reduced the fluoride adsorption on the enamel surface. Therefore, the surfactants tested (except for P20) changed the enamel surface energy. The SLS decreased the protective potential of NaF on initial erosion, but no tested agent interfered with the protective effect of NaF on enamel erosive wear.

The oral microbiome - an update for oral healthcare professionals

For millions of years, our resident microbes have coevolved and coexisted with us in a mostly harmonious symbiotic relationship. We are not distinct entities from our microbiome, but together we form a 'superorganism' or holobiont, with the microbiome playing a significant role in our physiology and health. The mouth houses the second most diverse microbial community in the body, harbouring over 700 species of bacteria that colonise the hard surfaces of teeth and the soft tissues of the oral mucosa. Through recent advances in technology, we have started to unravel the complexities of the oral microbiome and gained new insights into its role during both health and disease. Perturbations of the oral microbiome through modern-day lifestyles can have detrimental consequences for our general and oral health. In dysbiosis, the finely-tuned equilibrium of the oral ecosystem is disrupted, allowing disease-promoting bacteria to manifest and cause conditions such as caries, gingivitis and periodontitis. For practitioners and patients alike, promoting a balanced microbiome is therefore important to effectively maintain or restore oral health. This article aims to give an update on our current knowledge of the oral microbiome in health and disease and to discuss implications for modern-day oral healthcare.

Effect of Decontamination and Cleaning on the Shear Bond Strength of High Translucency Zirconia

(1) Background: This study evaluated the bonding performance of high translucency zirconia after diverse surficial decontamination and cleaning procedures. (2) Methods: High translucency zirconia (Lava^TM Esthetic) specimens (2.0 mm × 20 mm × 10 mm) were exposed to different surface treatments prior to bonding to CoCr cylinders (d = 5 mm, height = 3 mm). All surfaces were sandblasted (40 µm aluminum oxide, 2 bar) and treated with alcohol (al), saliva (s), saliva + water (sw), or saliva + NaOCl + water (sn) before bonding was performed with the following adhesive luting systems: RelyX^TM Unicem 2 (RX), Scotchbond^TM Universal (SBU) + RelyX^TM Ultimate (RU) or Monobond Plus (MP) + Multilink^® Automix (ML). After 24 h, thermocycling (TC:12,000 × 5 °C/55 °C) and 90 days of storage at 37 °C in distilled water, the shear bond strength (SBS) was evaluated according to ISO/TS 11,405:2015. Failure modes along bonding areas were characterized. Means and standard deviations (n = 10 per group) were determined and statistically analyzed with one-way ANOVA/Bonferroni (α = 0.05). (3) Results: The SBS after 24 h varied between 3.5 (sRX) and 69.4 MPa (snMP + ML). Values from 0 (sRX) to 70.3 MPa (swRX) were found after TC. Data after 90 days of storage showed the lowest values for sRX (0 MPa) and the highest values for alSBU + RU (75.5 MPa). Adhesive failure was noted at all aging conditions. (4) Conclusions: SBU + RU or RX and MP + ML including saliva decontamination of the ceramic surface with water or NaOCl + water allow efficient bonding to Lava^TM Esthetic.

Effects of Lectins on initial attachment of cariogenic Streptococcus mutans

Oral bacteria initiate biofilm formation by attaching to tooth surfaces via an interaction of a lectin-like bacterial protein with carbohydrate chains on the pellicle. This study aimed to find naturally derived lectins that inhibit the initial attachment of a cariogenic bacterial species, Streptococcus mutans (S. mutans), to carbohydrate chains in saliva in vitro. Seventy kinds of lectins were screened for candidate motifs that inhibit the attachment of S. mutans ATCC 25175 to a saliva-coated culture plate. The inhibitory effect of the lectins on attachment of the S. mutans to the plates was quantified by crystal violet staining, and the biofilm was observed under a scanning electron microscope (SEM). Surface plasmon resonance (SPR) analysis was performed to examine the binding of S. mutans to carbohydrate chains and the binding of candidate lectins to carbohydrate chains, respectively. Moreover, binding assay between the biotinylated-lectins and the saliva components was conducted to measure the lectin binding. Lectins recognizing a salivary carbohydrate chain, Galβ1-3GalNAc, inhibited the binding of S. mutans to the plate. In particular, Agaricus bisporus agglutinin (ABA) markedly inhibited the binding. This inhibition was confirmed by SEM observation. SPR analysis indicated that S. mutans strongly binds to Galβ1-3GalNAc, and ABA binds to Galβ1-3GalNAc. Finally, the biotinylated Galβ1-3GalNAc-binding lectins including ABA demonstrated marked binding to the saliva components. These results suggest that ABA lectin inhibited the attachment of S. mutans to Galβ1-3GalNAc in saliva and ABA can be useful as a potent inhibitor for initial attachment of oral bacteria and biofilm formation.

The presence of acquired enamel pellicle changes acid-induced erosion from dissolution to a softening process

Erosive wear undermines the structural properties of enamel resulting in irreversible enamel loss. A thin protein layer formed from natural saliva on tooth surfaces, acquired enamel pellicle (AEP), protects against erosive wear. The exact components in saliva responsible for such protection are not yet known. We prepared three solutions containing different components: proteins and ions [natural saliva (NS)], minerals with no proteins [artificial saliva (AS)] and neither proteins nor ions [deionised water (DW)]. To assess the protection of the three solutions against citric acid enamel erosion, enamel specimens were immersed in the corresponding solution for 24 h. All specimens were then exposed to five erosion cycles, each consisted of a further 30 min immersion in the same solution followed by 10-min erosion. Mean step height using a non-contacting profilometer, mean surface microhardness (SMH) using Knoop microhardness tester (final SMH), and roughness and 2D profiles using atomic force microscopy were measured after five cycles. The final SMH values were compared to the starting values (after 24 hr). NS group had significantly less tissue loss but greater SMH change (P < 0.0001) than AS and DW groups. Specimens in NS were softer and rougher (P < 0.001) but less eroded than specimens in AS and DW.

Dysbiosis as a determinant factor of systemic and oral pathology: importance of microbiome

Advances in genetic and epigenetic studies modified some concepts of health and disease that had been kept intact for decades. In this respect, in the last few years, microorganisms that have evolved with superior life forms for millions of years have taken an increased prominence. The genes of organisms and their microbiota constitute a microbiome that intervenes in health maintenance. The oral cavity is inhabited by a variety of microorganisms, their control aids in stabilising oral and systemic disease. The objective of this article is to update some concepts related to oral microbiome and its correlation with general and oral health.

Inhibition of α-Amylases by Condensed and Hydrolysable Tannins: Focus on Kinetics and Hypoglycemic Actions

The aim of the present study was to compare the in vitro inhibitory effects on the salivary and pancreatic α-amylases and the in vivo hypoglycemic actions of the hydrolysable tannin from Chinese natural gall and the condensed tannin from Acacia mearnsii. The human salivary α-amylase was more strongly inhibited by the hydrolysable than by the condensed tannin, with the concentrations for 50% inhibition (IC₅₀) being 47.0 and 285.4 μM, respectively. The inhibitory capacities of both tannins on the pancreatic α-amylase were also different, with IC₅₀ values being 141.1 μM for the hydrolysable tannin and 248.1 μM for the condensed tannin. The kinetics of the inhibition presented complex patterns in that for both inhibitors more than one molecule can bind simultaneously to either the free enzyme of the substrate-complexed enzyme (parabolic mixed inhibition). Both tannins were able to inhibit the intestinal starch absorption. Inhibition by the hydrolysable tannin was concentration-dependent, with 53% inhibition at the dose of 58.8 μmol/kg and 88% inhibition at the dose of 294 μmol/kg. For the condensed tannin, inhibition was not substantially different for doses between 124.4 μmol/kg (49%) and 620 μmol/kg (57%). It can be concluded that both tannins, but especially the hydrolysable one, could be useful in controlling the postprandial glycemic levels in diabetes.