Antimicrobial effects of o-cymen-5-ol and zinc, alone & in combination in simple solutions and toothpaste formulations

Novel functions of o-cymen-5-ol nanoemulsion in reversing colistin resistance in multidrug-resistant Klebsiella pneumoniae infections

Multidrug resistance (MDR) Klebsiella pneumoniae (K. pneumoniae) is a major emerging threat to human health, and leads to very high mortality rate. The effectiveness of colistin, the last resort against MDR Gram-negative bacteria, is significantly compromised due to the widespread presence of plasmid- or chromosome-mediated resistance genes. In this study, o-cymen-5-ol has been found to greatly restore colistin sensitivity in MDR K. pneumoniae. Importantly, this compound does not impact bacterial viability, induce resistance, or cause any noticeable cell toxicity. Various routes disclosed the potential mechanism of o-cymen-5-ol potentiating colistin activity against MDR K. pneumoniae. These include inhibiting the activity of plasmid-mediated mobile colistin resistance gene (mcr-1), accelerating lipopolysaccharide (LPS) - mediated membrane damage, and promoting the ATP-binding cassette (ABC) transporter pathway. To enhance the administration and bioavailability of o-cymen-5-ol, a nanoemulsion has been designed, which significantly improves the loading efficiency and solubility of o-cymen-5-ol, resulting in antimicrobial potentiation of colistin against K. pneumoniae infection. This study has revealed a new understanding of the o-cymen-5-ol nanoemulsion as a means to enhance the effectiveness of colistin against resistant factors. The finding also suggests that o-cymen-5-ol nanoemulsion could be a promising approach in the development of potential treatments for multidrug-resistant Gram-negative bacterial infections.

Effects of Zinc Compounds on Lysozyme, Peroxidase, and α-Amylase from the Perspective of Oral Health: a Scoping Review

Zinc has been proposed as a topical therapeutic agent for the prevention and treatment of various oral diseases. The purpose of this scoping review was to investigate the effects of zinc on the enzymatic activities of lysozyme, peroxidase, and α-amylase from the perspective of developing oral health care products and therapeutic agents for oral diseases. A comprehensive review of the scientific literature was conducted on the direct interactions of zinc with lysozyme, peroxidase, and α-amylase from various sources. Most of the reports on the effects of zinc on the enzymatic activities of lysozyme, peroxidase, and α-amylase involved enzymes derived from bacteria, fungi, animals, and plants. Studies of human salivary enzymes were scarce. Zinc was found to inhibit the enzymatic activities of lysozyme, peroxidase, and α-amylase under diverse experimental conditions. The suggested mechanism was ionic interactions between zinc and enzyme molecules. The possibility that zinc causes structural changes to enzyme molecules has also been suggested. In conclusion, for zinc to be used as an effective topical therapeutic agent for oral health, further studies on the activity of human salivary enzymes are warranted, and additional information regarding the type and concentration of effective zinc compounds is also required.

Oral Microbiome: A Review of Its Impact on Oral and Systemic Health

PURPOSE OF REVIEW

This review investigates the oral microbiome's composition, functions, influencing factors, connections to oral and systemic diseases, and personalized oral care strategies.

RECENT FINDINGS

The oral microbiome is a complex ecosystem consisting of bacteria, fungi, archaea, and viruses that contribute to oral health. Various factors, such as diet, smoking, alcohol consumption, lifestyle choices, and medical conditions, can affect the balance of the oral microbiome and lead to dysbiosis, which can result in oral health issues like dental caries, gingivitis, periodontitis, oral candidiasis, and halitosis. Importantly, our review explores novel associations between the oral microbiome and systemic diseases including gastrointestinal, cardiovascular, endocrinal, and neurological conditions, autoimmune diseases, and cancer. We comprehensively review the efficacy of interventions like dental probiotics, xylitol, oral rinses, fluoride, essential oils, oil pulling, and peptides in promoting oral health by modulating the oral microbiome.

SUMMARY

This review emphasizes the critical functions of the oral microbiota in dental and overall health, providing insights into the effects of microbial imbalances on various diseases. It underlines the significant connection between the oral microbiota and general health. Furthermore, it explores the advantages of probiotics and other dental care ingredients in promoting oral health and addressing common oral issues, offering a comprehensive strategy for personalized oral care.

Investigation of the constituents of commercially available toothpastes

OBJECTIVES

Toothpaste plays a pivotal role in oral and dental hygiene. This cross-sectional study not only investigates the constituents of toothpastes available in the market and their frequency across different brands but also delves into the potential side effects, irritations, or unfavourable outcomes of these constituents, emphasizing the broader health and environmental implications.

METHODS

The largest of the five major chain markets in each district of Istanbul was visited, and adult toothpastes were included in this study. All the constituents that make up the toothpaste were individually recorded in an Excel database. Subsequently, literature regarding the purposes, toxic and potential side effects of each ingredient was gathered using databases such as Google Scholar, PubMed and ScienceDirect. The percentages of these ingredients' occurrence among all the toothpastes were calculated, and the ingredients were categorized into 15 distinct groups based on their usage purposes.

RESULTS

There were 160 different varieties of toothpaste belonging to 19 different brands on the market shelves. Although a total of 244 different ingredients were identified, only 78 of them were included in the study. Among the analysed toothpaste types, 105 of them were found to contain 1450 ppm fluoride, whilst 26 toothpaste variants were discovered to have fluoride levels below this value. Among the various ingredients analysed, particular attention was drawn to commonly debated compounds in oral care products. Specifically, titanium dioxide was found in 68% (n = 111) of the varieties, sodium lauryl sulphate in 67% (n = 108) and paraben in 2% (n = 4), respectively.

CONCLUSION

Whilst certain ingredients may raise concerns for potential side effects and health considerations within the human body, the toothpaste has long been regarded as an indispensable tool for maintaining optimal oral and dental health. However, gaining a deeper understanding and conducting research on each constituent that comprises the toothpaste, as well as raising awareness in this regard, holds significant importance for human health.

Ingredients in Commercially Available Mouthwashes

OBJECTIVES

Mouthwashes, a cornerstone of oral and dental hygiene, play a pivotal role in combating the formation of dental plaque, a leading cause of periodontal disease and dental caries. This study aimed to review the composition of mouthwashes found on retail shelves in Turkey and evaluate their prevalence and side effects, if any.

METHODS

The mouthwashes examined were sourced from the 5 largest chain stores in each district of Istanbul. A comprehensive list of the constituents was meticulously recorded. The research was supported by an extensive compilation of references from scholarly databases such as Google Scholar, PubMed, and ScienceDirect. Through rigorous analysis, the relative proportions of mouthwash ingredients and components were determined.

RESULTS

A total of 45 distinctive variations of mouthwashes, representing 17 prominent brands, were identified. Amongst the 116 ingredients discovered, 70 were evaluated for potential adverse effects and undesirable side effects. The aroma of the mouthwash (n = 45; 100%), as welll as their sodium fluoride (n = 28; 62.22%), sodium saccharin (n = 29; 64.44%), sorbitol (n = 21; 46.6%), and propylene glycol (n = 28; 62.22%) content were the main undesireable features.

CONCLUSIONS

The limited array of mouthwashes found on store shelves poses a concern for both oral and public health. Furthermore, the intricate composition of these products, consisting of numerous ingredients with the potential for adverse effects, warrants serious attention. Both clinicians and patients should acknowledge the importance and unwarranted side effects of the compnents of the mouthwashes.

An In Vitro Study to Evaluate the Antimicrobial Activity of a Zinc Citrate, Sodium Fluoride, Alum and Xylitol-Based Toothpaste Formulation

INTRODUCTION

Periodontitis is a prevalent condition significantly affecting oral health. Comorbid conditions, such as diabetes, can heighten the severity of periodontal disease and overall oral health. Therefore, to enhance oral health and manage comorbid conditions, comprehensive periodontal care is essential. This approach could involve using toothpaste containing antimicrobial ingredients in routine oral care. This paper presents the results of an in vitro study analysing the antimicrobial properties of the test formulation containing zinc citrate, alum, sodium fluoride, and xylitol-based toothpaste (Stolin-R). These ingredients work together to help in providing comprehensive oral care by controlling growth of bacteria majorly responsible for periodontal disease and thus maintaining optimal oral hygiene.

AIM

To determine the antimicrobial properties of zinc citrate, alum, sodium fluoride, and xylitol-based toothpaste formulation against key periodontal pathogens through in vitro analyses.

MATERIALS AND METHODS

The antimicrobial efficacy of test formulation is evaluated through minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-dependent antibacterial assessment against key periodontal pathogens, including Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, Streptococcus mutans, and Bacteroides fragilis.

RESULTS

The test formulation demonstrated potent antimicrobial effectiveness against Bacteroides fragilis, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Streptococcus mutans, and Tannerella forsythia, by exhibiting low MIC and MBC. Additionally, significant bacterial reduction, exceeding 99.99%, was observed within five minutes, emphasising its potential as an effective adjunct in combating periodontal infection.

CONCLUSION

Zinc citrate, alum, sodium fluoride, and xylitol-based toothpaste formulation demonstrates significant antimicrobial activity against key periodontal pathogens, suggesting its potential as an effective agent for maintaining oral health and combating gingival infection.

Effects of Zinc Compounds on the Enzymatic Activities of Lysozyme and Peroxidase and Their Antifungal Activities

This study aimed to investigate the effects of zinc compounds on the enzymatic activities of lysozyme, peroxidase, and the glucose oxidase-mediated peroxidase (GO-PO) system and their antifungal activities. Four different zinc compounds (zinc chloride, gluconate, lactate, and sulfate) were incubated with hen egg-white lysozyme (HEWL), bovine lactoperoxidase (bLPO), the GO-PO system, and human unstimulated whole saliva in solution and on a hydroxyapatite surface. Enzymatic activities of lysozyme, peroxidase, and the GO-PO system were measured through the hydrolysis of Micrococcus lysodeikticus, oxidation of fluorogenic 2',7'-dichlorofluorescin, and glucose assay, respectively. Interactions between zinc and enzymes were analyzed by surface plasmon resonance (SPR). The minimum inhibitory concentration (MIC) and candidacidal activities of zinc compounds were examined against three Candida albicans strains. Zinc gluconate and sulfate significantly increased the enzymatic activities of salivary lysozyme in the solution assay and of HEWL and salivary lysozyme on the hydroxyapatite surface. However, all examined zinc compounds significantly decreased the enzymatic activities of bLPO and salivary peroxidase in solution and on the surface. SPR analyses revealed binding of zinc to lysozyme and peroxidase, with affinity differing according to the zinc compounds. The MIC of zinc compounds against C. albicans was 1.0-2.4 mM. Candidacidal activities were 17.7-38.8% and 23.7-47.0% at 1.0 and 10 mM concentrations, respectively. In conclusion, zinc compounds enhanced lysozyme activity but inhibited peroxidase activity. Zinc compounds exhibited concentration-dependent candidacidal activity against C. albicans. Zinc compounds are potential therapeutic agents for oral health, especially for geriatric patients.

Antimicrobial Activity of Zinc against Periodontal Pathogens: A Systematic Review of In Vitro Studies

Background and Objectives: More than a billion people worldwide suffer from chronic periodontitis. The primary etiological factor of periodontal diseases is dental plaque and the bacteria it contains, particularly Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans. Zinc, owing to its antibacterial properties, can be employed in periodontology. The objective of this review was to analyze scientific literature that examines the effects of zinc on periopathogens. Materials and methods: A systematic review protocol of scientific literature was designed following PRISMA recommendations. Data search was conducted in PubMed, Web of Science, and ScienceDirect databases. Full-text articles in English that examine the effects of zinc on periopathogens and were published between 2011 and 2021 were included. Results: Fifteen articles were included in the analysis based on inclusion criteria. ZnO exhibited antibacterial activity against P. gingivalis and P. intermedia (p < 0.001). The minimum inhibitory concentration against P. gingivalis was 10 μg/mL. ZnO demonstrated a significant antibacterial effect, as evidenced by inhibition zones of 15.10 mm for S. oralis, 13.36 mm for P. gingivalis, 12.98 mm for S. sanguis, and 14.01 mm for P. intermedia. Zn (II)-based polymers inhibited the ragA and ragB genes of P. gingivalis. Titanium dental implants coated with ZnO effectively disrupted the cell walls of P. gingivalis and A. actinomycetemcomitans. ZnO inhibited the growth of P. gingivalis within 2 h and the growth of F. nucleatum and P. intermedia within 3 h. ZnO exhibited nontoxic effects, and concentrations up to 0.8 mg/L increased cell survival rates by up to 90%. Conclusions: The analysis of the literature confirms the antibacterial action of zinc against periodontal pathogenic bacteria. At low concentrations, these substances do not exhibit cytotoxic effects on fibroblasts.

Short-term anti-plaque effect of a cymenol mouthwash analysed using the DenTiUS Deep Plaque software: a randomised clinical trial

BACKGROUND

The effect of cymenol mouthwashes on levels of dental plaque has not been evaluated thus far.

OBJECTIVE

To analyse the short-term, in situ, anti-plaque effect of a 0.1% cymenol mouthwash using the DenTiUS Deep Plaque software.

METHODS

Fifty orally healthy participants were distributed randomly into two groups: 24 received a cymenol mouthwash for eight days (test group A) and 26 a placebo mouthwash for four days and a cymenol mouthwash for a further four days thereafter (test group B). They were instructed not to perform other oral hygiene measures. On days 0, 4, and 8 of the experiment, a rinsing protocol for staining the dental plaque with sodium fluorescein was performed. Three intraoral photographs were taken per subject under ultraviolet light. The 504 images were analysed using the DenTiUS Deep Plaque software, and visible and total plaque indices were calculated (ClinicalTrials ID NCT05521230).

RESULTS

On day 4, the percentage area of visible plaque was significantly lower in test group A than in test group B (absolute = 35.31 ± 14.93% vs. 46.57 ± 18.92%, p = 0.023; relative = 29.80 ± 13.97% vs. 40.53 ± 18.48%, p = 0.024). In comparison with the placebo, the cymenol mouthwash was found to have reduced the growth rate of the area of visible plaque in the first four days by 26% (absolute) to 28% (relative). On day 8, the percentage areas of both the visible and total plaque were significantly lower in test group A than in test group B (visible absolute = 44.79 ± 15.77% vs. 65.12 ± 16.37%, p < 0.001; visible relative = 39.27 ± 14.33% vs. 59.24 ± 16.90%, p < 0.001; total = 65.17 ± 9.73% vs. 74.52 ± 13.55%, p = 0.007). Accounting for the growth rate with the placebo mouthwash on day 4, the above results imply that the cymenol mouthwash in the last four days of the trial reduced the growth rate of the area of visible plaque (absolute and relative) by 53% (test group A) and 29% (test group B), and of the area of total plaque by 48% (test group A) and 41% (test group B).

CONCLUSIONS

The 0.1% cymenol mouthwash has a short-term anti-plaque effect in situ, strongly conditioning the rate of plaque growth, even in clinical situations with high levels of dental plaque accumulation.

Modulation of Biofilm Formation and Permeability in Streptococcus mutans during Exposure To Zinc Acetate

The penetration of biofilms by antimicrobials is a potential limiting factor in biofilm control. This is relevant to oral health, as compounds that are used to control microbial growth and activities could also affect the permeability of dental plaque biofilm with secondary effects on biofilm tolerance. We investigated the effects of zinc salts on the permeability of Streptococcus mutans biofilms. Biofilms were grown with low concentrations of zinc acetate (ZA), and a transwell transportation assay was applied to test biofilm permeability in an apical-basolateral direction. Crystal violet assays and total viable counts were used to quantify the biofilm formation and viability, respectively, and short time frame diffusion rates within microcolonies were determined using spatial intensity distribution analysis (SpIDA). While the diffusion rates within biofilm microcolonies were not significantly altered, exposure to ZA significantly increased the overall permeability of S. mutans biofilms (P < 0.05) through decreased biofilm formation, particularly at concentrations above 0.3 mg/mL. Transport was significantly lower through biofilms grown in high sucrose conditions. IMPORTANCE Zinc salts are added to dentifrices to improve oral hygiene through the control of dental plaque. We describe a method for determining biofilm permeability and show a moderate inhibitory effect of zinc acetate on biofilm formation, and that this inhibitory effect is associated with increases in overall biofilm permeability.

A mouthwash formulated with o-cymen-5-ol and zinc chloride specifically targets potential pathogens without impairing the native oral microbiome in healthy individuals

Background

Many antimicrobial compounds in mouthwashes can have a negative impact on the oral microbiome. O-cymen-5-ol, a compound derived from a phytochemical, has a targeted mode of action and is being used as an alternative. However, its effect on the native oral microbiome is unknown.

Aim

To assess the effect of a mouthwash formulated with o-cymen-5-ol and zinc chloride on the oral microbiome of healthy individuals.

Methods

A mouthwash formulated with o-cymen-5-ol and zinc chloride was administered to a cohort of 51 volunteers for 14 days, while another cohort of 49 volunteers received a placebo. The evolution of the oral microbiome in both groups was analysed using a metataxonomic approach.

Results

Analysis of the oral microbiome showed that the mouthwash selectively targeted potential oral pathogens while maintaining the integrity of the rest of the microbiome. Specifically, the relative abundance of several potentially pathogenic bacterial taxa, namely Fusobacteriota, Prevotella, Actinomyces, Granulicatella, Abiotrophia, Lautropia, Lachnoanaerobaculum, Eubacterium (nodatum group) and Absconditabacteriales (SR1) decreased, while the growth of Rothia, a nitrate-reducing bacterium beneficial for blood pressure, was stimulated.

Conclusions

The use of o-cymen-5-ol and zinc chloride as antimicrobial agents in oral mouthwashes is a valuable alternative to classical antimicrobial agents.

Zinc and Zinc Transporters in Dermatology

Zinc is an important trace mineral in the human body and a daily intake of zinc is required to maintain a healthy status. Over the past decades, zinc has been used in formulating topical and systemic therapies for various skin disorders owing to its wound healing and antimicrobial properties. Zinc transporters play a major role in maintaining the integrity of the integumentary system by controlling zinc homeostasis within dermal layers. Mutations and abnormal function of zinc-transporting proteins can lead to disease development, such as spondylocheirodysplastic Ehlers-Danlos syndrome (SCD-EDS) and acrodermatitis enteropathica (AE) which can be fatal if left untreated. This review discusses the layers of the skin, the importance of zinc and zinc transporters in each layer, and the various skin disorders caused by zinc deficiency, in addition to zinc-containing compounds used for treating different skin disorders and skin protection.

Establishment of novel in vitro culture system with the ability to reproduce oral biofilm formation on dental materials

Intensive research has been conducted with the aim of developing dental restorative/prosthetic materials with antibacterial and anti-biofilm effects that contribute to controlling bacterial infection in the oral cavity. In situ evaluations were performed to assess the clinical efficacy of these materials by exposing them to oral environments. However, it is difficult to recruit many participants to collect sufficient amount of data for scientific analysis. This study aimed to assemble an original flow-cell type bioreactor equipped with two flow routes and assess its usefulness by evaluating the ability to reproduce in situ oral biofilms formed on restorative materials. A drop of bacterial suspension collected from human saliva and 0.2% sucrose solution was introduced into the assembled bioreactor while maintaining the incubation conditions. The bioreactor was able to mimic the number of bacterial cells, live/dead bacterial volume, and volume fraction of live bacteria in the in situ oral biofilm formed on the surface of restorative materials. The usefulness of the established culture system was further validated by a clear demonstration of the anti-biofilm effects of a glass-ionomer cement incorporating zinc-releasing glasses when evaluated by this system.

Antibacterial effects and physical properties of a glass ionomer cement containing BioUnion filler with acidity-induced ability to release zinc ion

BioUnion filler is a bioactive glass particle that releases Zn²⁺ in an acidic environment. In this study, the ion release, antibacterial, and physical properties of a glass ionomer cement (GIC) incorporating BioUnion filler (CA) were assessed in vitro. The concentration of Zn²⁺ released from CA into acetic acid was higher than that released into water and its minimum inhibitory concentrations against six oral bacterial species. Moreover, the concentration of Zn²⁺-release was maintained during all the seven times it was exposed to acetic acid. Compared to a conventional cement and resin composite, CA significantly inhibited the growth of oral bacteria and hindered their adhesion on the material surface. Thus, our study outcomes show that the release of Zn²⁺ from CA in the acidic environment does not affect its compressive strength.

Effectiveness of Antibacterial Surfaces in Osseointegration of Titanium Dental Implants: A Systematic Review

Titanium (Ti) dental implant failure as a result of infection has been established at 40%, being regarded as one of the most habitual and untreatable problems. Current research is focused on the design of new surfaces that can generate long-lasting, infection-free osseointegration. The purpose of our study was to assess studies on Ti implants coated with different antibacterial surfaces, assessing their osseointegration. The PubMed, Web of Science and Scopus databases were electronically searched for in vivo studies up to December 2020, selecting six studies that met the inclusion criteria. The quality of the selected studies was assessed using the ARRIVE (Animal Research: Reporting of In Vivo Experiments) criteria and Systematic Review Center for Laboratory animal Experimentation's (SYRCLE's) risk of bias tool. Although all the included studies, proved greater osseointegration capacity of the different antibacterial surfaces studied, the methodological quality and experimental models used in some of them make it difficult to draw predictable conclusions. Because of the foregoing, we recommend caution when interpreting the results obtained.

Evaluation of ion release and the recharge ability of glass-ionomer cement containing BioUnion filler using an in vitro saliva-drop setting assembly

OBJECTIVE

A glass-ionomer cement (GIC) containing BioUnion filler has been reported to release Zn²⁺ under acidic conditions and to inhibit oral bacteria on its surface. However, previous results are based on in vitro experiments under static conditions. This study aimed to assemble an in vitro saliva-drop setting to simulate in vivo conditions of the oral cavity and to investigate the ion releasing and recharging properties of the GIC containing BioUnion filler.

METHODS

The effective concentrations of Zn²⁺ and F^- against Streptococcus mutans and saliva-derived multi-species biofilms were determined. Artificial saliva was dropped on the GIC containing BioUnion filler using the in vitro saliva-drop setting assembly and was periodically replaced with acetic acid. Ion release/recharge properties were investigated by measuring the release concentrations of Zn²⁺ and F^-.

RESULTS

The concentration of Zn²⁺ released from the BioUnion filler-containing GIC during seven days with repeated exposure to acid could be maintained at the level to inhibit S. mutans and saliva-derived multi-species biofilm formation. Moreover, the BioUnion filler-containing GIC could be recharged with Zn²⁺ and F^- by the application of a tooth gel containing Zn²⁺ and F^-. The release concentration of Zn²⁺ after recharging was significantly higher than the effective concentration of Zn²⁺ to hinder S. mutans and saliva-derived multi-species biofilm formation on material surfaces.

SIGNIFICANCE

The GIC containing BioUnion filler was shown to have the potential to inhibit biofilm formation in the oral cavity. In addition, recharging Zn²⁺ and F^- would further enhance the effect of the GIC containing BioUnion filler.

Antibacterial Activity of Hybrid Polymeric Scaffold for Reconstruction of Tubular Bone Defects

We studied antibacterial activity of a hybrid polymeric construction consisting of continuous and porous layers of ultrahigh-molecular-weight polyethylene reinforced by titanium. Experimental samples were impregnated with amoxycillin in subcritical Freon R22. The contact of bacterial culture with hybrid polymeric constructions saturated with amoxycillin suppressed the growth of microorganisms and the formation of their colonies. These results attest to the presence of a bactericidal effect of hybrid scaffold samples impregnated with an antibacterial component.

A systematic review on antibacterial activity of zinc against Streptococcus mutans

OBJECTIVES

The aim of this study was to systematically review the growth inhibition effectiveness of zinc against Streptococcus mutans. The main question was, "Does the zinc inhibit the growth of oral Streptococcus mutans in vitro?

METHODS

Literature search on PubMed, Medline, and science direct databases was carried out for in vitro studies published in English from 1990 to 2016, and the reported outcomes of minimum inhibitory concentration (MIC), minimum bactericidal concentrations (MBC), zone of inhibition (ZOI) and bacterial count method using colony forming unit (CFU) were used to assess the antibacterial effectiveness of zinc.

RESULTS

Seventeen studies were included in this review. Seven studies reported MIC and MBC. Four studies reported ZOI, and eight studies reported CFU. MIC values using zinc chloride and zinc oxide nanoparticles were ranged from 0.025 to 0.2 mM and 0.390 to 500 ± 306.18 µg/ml respectively. MBC values using zinc oxide nanoparticles have ranged from 3.125 to 500 µg/ml. ZOI ranged from no inhibition zone to 21 ± 1.4 mm using 23.1% zinc oxide. A considerable reduction in the bacterial count was reported after adding zinc. However, only two studies have reported no inhibitory effect of zinc.

CONCLUSION

This review indicated a significant growth inhibition effectiveness of zinc even at lower concentrations which indicate it's safely to be used in oral health products.

Antibacterial and bioactive coatings on titanium implant surfaces

Various surface modifications have been tried for enhancing osseointegration of the dental implants like mechanical and/or chemical treatments and deposition of calcium phosphate coatings. The objective of this research was to develop calcium-phosphate based thin coatings with antibacterial and bioactive properties for potential application in dental implants. Titanium (Ti) discs were immersed in different calcifying solutions: CaP (positive control), F-CaP, Zn-CaP, and FZn-CaP and incubated for 24 h. Negative control was uncoated Ti discs. Coated surfaces were characterized using X-ray diffraction, scanning electron microscopy and energy dispersive spectroscopy. Antibacterial properties were tested using Porphyromonas gingivalis because of its strong association with periodontal and peri-implant infections. Bacterial adhesion and colonization were studied at different timepoints. The coated surfaces had compositional characteristics similar to that of bone mineral and they inhibited the growth, colonization and adherence of P. gingivalis, resulted in reduced thickness of biofilms and bacterial inhibition in the culture medium as compared to the positive and negative controls (p < 0.05). There was no significant difference between the experimental groups (p > 0.05). It has been previously demonstrated that these coatings have excellent in vitro bioactivity (formed carbonate hydroxyapatite when immersed in a simulated body fluid). Such coatings can enhance osseointegration and prevent infection in implants, thereby improving the success rates of implants. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2218-2227, 2017.

Transition Metal Homeostasis in Streptococcus pyogenes and Streptococcus pneumoniae

Trace metals such as Fe, Mn, Zn and Cu are essential for various biological functions including proper innate immune function. The host immune system has complicated and coordinated mechanisms in place to either starve and/or overload invading pathogens with various metals to combat the infection. Here, we discuss the roles of Fe, Mn and Zn in terms of nutritional immunity, and also the roles of Cu and Zn in metal overload in relation to the physiology and pathogenesis of two human streptococcal species, Streptococcus pneumoniae and Streptococcus pyogenes. S. pneumoniae is a major human pathogen that is carried asymptomatically in the nasopharynx by up to 70% of the population; however, transition to internal sites can cause a range of diseases such as pneumonia, otitis media, meningitis and bacteraemia. S. pyogenes is a human pathogen responsible for diseases ranging from pharyngitis and impetigo, to severe invasive infections. Both species have overlapping capacity with respect to metal acquisition, export and regulation and how metal homeostasis relates to their virulence and ability to invade and survive within the host. It is becoming more apparent that metals have an important role to play in the control of infection, and with further investigations, it could lead to the potential use of metals in novel antimicrobial therapies.

Material compatibility and antimicrobial activity of consumer products commonly used to clean dentures

STATEMENT OF PROBLEM

Regular denture cleaning is essential to good oral health, but only limited evidence is available regarding the effects of common cleaning routines.

PURPOSE

The purpose of this in vitro study was to determine the compatibility of denture materials with and the antimicrobial effects of typical cleaning regimens.

MATERIAL AND METHODS

The evaluated treatments were derived from a study of dental professional recommendations and consumer habits, including denture cleanser tablets, toothpaste, mouthwash, isopropyl alcohol (IPA), household bleach, soap, and vinegar. The material integrity of denture materials, including polymethyl methacrylate (PMMA) and metals, was evaluated by scanning electron microscopy and profilometry after treatment with laboratory regimens simulating 2 years of typical consumer use. Treatments were also evaluated in a microbial kill time assay against a range of oral microorganisms with typical treatment regimens.

RESULTS

Alcohol-based mouthwash and IPA damaged the surface of PMMA, and brushing with toothpaste caused scratching and surface material loss. Bleach caused limited damage to PMMA, but corroded CoCr alloy (pitting) and solder (layer formation). Denture tablets caused little damage to any materials apart from the layer formation on silver solder. Vinegar and soap were compatible with all materials. In antimicrobial assays, bleach gave excellent results, and IPA and mouthwash required concentrated dilutions to be effective. Cleanser tablets were effective at 5 minutes treatment time against all organisms. Toothpaste was effective against bacteria but not Candida albicans. Vinegar, soaps, salt, and sodium bicarbonate were microbially ineffective.

CONCLUSIONS

Bleach was highly antimicrobial but incompatible with metal dental prosthesis components. IPA and mouthwash were antimicrobial but damaged PMMA. Specialist denture cleanser tablets gave a good combination of microbial efficacy and reasonable material compatibility.

Antibacterial property expressed by a novel calcium phosphate glass

We have developed a calcium phosphate glass (CPG) doped with Zn(2+) or F(-) or combined Zn(2+) and F(-) ions, which are naturally found in the human body and play a dual role in bone formation and antibacterial activity. Previously, we have demonstrated that this family of CPGs has superior osteoconductive and resorbable properties in vivo. This study aimed to investigate the antibacterial property of CPGs incorporating Zn(2+) and/or F(-) . We used Streptococcus mutans as a model organism because it is one of the major human oral pathogens and an early colonizer, and it has been associated with several oral infections, such as dental caries, periodontitis, and peri-implantitis. CPGs of 0.01 and 0.05 g were incubated with S. mutans for 0, 2, 4, and 6 h. Serial dilutions were plated in triplicate and colony forming units were determined. The antimicrobial effect of CPG incorporating Zn(2+) or F(-) was greater than CPG incorporating both these ions. CPG without doping produced a moderate antimicrobial effect. This family of CPGs, previously shown to promote new bone formation in vivo, is demonstrated to have superior bactericidal properties.

A randomised clinical trial to assess maintenance of gingival health by a novel gel to foam dentifrice containing 0.1%w/w o-cymen-5-ol, 0.6%w/w zinc chloride

OBJECTIVES

To assess the ability of 0.1%w/w o-cymen-5-ol/ 0.6%w/w zinc chloride gel to foam dentifrice to maintain gingival health compared to a sodium fluoride control dentifrice.

DESIGN

Following a baseline examination, subjects went through a regimen to bring them to a high level of gingival health. This involved a professional dental prophylaxis supported by oral hygiene instruction prior to commencing study treatment. Subjects brushed twice daily for 12 weeks with either the test or control dentifrice. Examinations for gingival inflammation (MGI), bleeding and plaque were performed after 12 weeks.

RESULTS

205 subjects were included in the efficacy analysis. Relative to the sodium fluoride/ silica control dentifrice group the o-cymen-5-ol/ zinc chloride gel to foam dentifrice exhibited statistically significant reductions (p<0.0001) in MGI, bleeding and plaque of 32.2%, 26.3% and 20.7% respectively after 12 weeks.

CONCLUSION

The results of the present clinical study demonstrate that the use of the 0.1%w/w o-cymen-5-ol/ 0.6%w/w zinc chloride gel to foam dentifrice over a 12 week period provides a statistically significant benefit in maintaining gingival health compared to a sodium fluoride control dentifrice.

Benefits of a silica-based fluoride toothpaste containing o-cymen-5-ol, zinc chloride and sodium fluoride

Fluoride toothpastes in conjunction with tooth brushing are used to clean teeth, control plaque build-up and for anti-caries benefits. Toothpastes are designed with attractive flavours and appearances to encourage regular prolonged use to maximise these benefits. The incorporation of additional ingredients into toothpaste is a convenient way to provide supplementary protection that fits into people's everyday oral care routine. Such ingredients should not compromise the primary health benefits of toothpaste nor discourage its use. o-Cymen-5-ol and zinc chloride have been incorporated into a sodium fluoride (NaF)/silica toothpaste at 0.1%w/w and 0.6%w/w respectively to provide additional benefits. These include improved gingival health maintenance, in terms of the reduction of plaque, gingival index and bleeding, and an immediate and long lasting reduction in volatile sulfur compounds (VSCs) measured on breath. These benefits can be attributed to the antimicrobial and neutralisation actions of the toothpaste. The use of established fluoride models demonstrated no compromise in NaF bioavailability. The toothpaste was formulated without compromising product aesthetics. The combination of o-cymen-5-ol and zinc chloride in toothpaste gave superior maintenance of gingival health and reduction in malodour related VSCs without compromising the primary health benefits of the toothpaste or diminishing attributes preferred for the product's use.

Maintenance of gingival health post professional care

Oral hygiene habits are strongly associated with general health behaviours; good oral self care should result in good dental health. Clinical dental hygiene services have limited long range probability of success if the patient is not diligent in the daily procedures of personal care to remove and control dental plaque. Therefore, it is important to help make the individual aware of their own ability to control and maintain good oral health after a dental prophylaxis through oral care instruction and the use of select antimicrobials to maintain the gingival health. This paper reviews the evidence outlining the relative roles of prophylaxis and correct oral self-care in maintaining gingival health.