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Fine N, Barbour A, Kaura K, Kerns KA, Chen D, Trivedi HM, Gomez J, Sabharwal A, McLean JS, Darveau RP, Glogauer M. Effects of a stabilized stannous fluoride dentifrice on clinical, immunomodulatory, and microbial outcomes in a human experimental gingivitis model. J Periodontol 2024; 95:421-431. [PMID: 37885337 DOI: 10.1002/jper.22-0710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Stannous fluoride dentifrice is well established for its beneficial clinical effects. In this study, we evaluated the effects of stannous fluoride on inflammation and oral microbiome. METHODS In this randomized, parallel-arm, double-blind, controlled clinical trial, we compared clinical resolution of experimental gingivitis by evaluating bleeding on probing, gingival index, and plaque index between stannous fluoride stabilized with zinc phosphate (test) and sodium fluoride (control) dentifrices. Further, these groups were compared for oral neutrophil counts, systemic priming of neutrophils, gingival crevicular fluid (GCF) expression of inflammatory markers, and the oral microbiome. RESULTS We found significant reduction in bleeding on probing in the test group compared to the control group in experimental gingivitis when participants used the test dentifrice prior to induction of experimental gingivitis. The test group also showed significant reductions in GCF levels of inflammatory markers (matrix metalloproteinase 8 [MMP8], receptor activator of nuclear factor kappa-Β ligand [RANKL]), oral polymorphonuclear neutrophil (PMN) counts, and systemic neutrophil priming (CD11b expression) during experimental gingivitis. Further, significant reductions in the gram-negative genera Porphyromonas, Tannerella, and Treponema were noted in the test group. CONCLUSION The stannous fluoride stabilized with zinc phosphate dentifrice formulation demonstrated clinical reduction in gingival inflammation and a beneficial effect on microbiome and immune markers. This intervention should be explored as a preventive aid in the progression of plaque-induced gingivitis to periodontitis.
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Affiliation(s)
- Noah Fine
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | | | - Kamini Kaura
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Kristopher A Kerns
- Department of Periodontics, University of Washington, Seattle, Washington, USA
| | - Dandan Chen
- Department of Oral Health Research, Colgate Palmolive Company, Piscataway, New Jersey, USA
| | - Harsh M Trivedi
- Department of Oral Health Research, Colgate Palmolive Company, Piscataway, New Jersey, USA
| | - Juliana Gomez
- Department of Oral Health Research, Colgate Palmolive Company, Piscataway, New Jersey, USA
| | - Amarpreet Sabharwal
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jeffrey S McLean
- Department of Periodontics, University of Washington, Seattle, Washington, USA
- Department of Microbiology, University of Washington, Seattle, Washington, USA
| | - Richard P Darveau
- Department of Periodontics, University of Washington, Seattle, Washington, USA
- Department of Microbiology, University of Washington, Seattle, Washington, USA
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
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Spatafora G, Li Y, He X, Cowan A, Tanner ACR. The Evolving Microbiome of Dental Caries. Microorganisms 2024; 12:121. [PMID: 38257948 PMCID: PMC10819217 DOI: 10.3390/microorganisms12010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/28/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Dental caries is a significant oral and public health problem worldwide, especially in low-income populations. The risk of dental caries increases with frequent intake of dietary carbohydrates, including sugars, leading to increased acidity and disruption of the symbiotic diverse and complex microbial community of health. Excess acid production leads to a dysbiotic shift in the bacterial biofilm composition, demineralization of tooth structure, and cavities. Highly acidic and acid-tolerant species associated with caries include Streptococcus mutans, Lactobacillus, Actinomyces, Bifidobacterium, and Scardovia species. The differences in microbiotas depend on tooth site, extent of carious lesions, and rate of disease progression. Metagenomics and metatranscriptomics not only reveal the structure and genetic potential of the caries-associated microbiome, but, more importantly, capture the genetic makeup of the metabolically active microbiome in lesion sites. Due to its multifactorial nature, caries has been difficult to prevent. The use of topical fluoride has had a significant impact on reducing caries in clinical settings, but the approach is costly; the results are less sustainable for high-caries-risk individuals, especially children. Developing treatment regimens that specifically target S. mutans and other acidogenic bacteria, such as using nanoparticles, show promise in altering the cariogenic microbiome, thereby combatting the disease.
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Affiliation(s)
- Grace Spatafora
- Biology and Program in Molecular Biology and Biochemistry, Middlebury College, Middlebury, VT 05753, USA
| | - Yihong Li
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA;
| | - Xuesong He
- ADA-Forsyth Institute, Cambridge, MA 02142, USA;
| | - Annie Cowan
- The Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
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Moran GP, Zgaga L, Daly B, Harding M, Montgomery T. Does fluoride exposure impact on the human microbiome? Toxicol Lett 2023; 379:11-19. [PMID: 36871794 DOI: 10.1016/j.toxlet.2023.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023]
Abstract
Fluoride is added to drinking water in some countries to prevent tooth decay (caries). There is no conclusive evidence that community water fluoridation (CWF) at WHO recommended concentrations for caries prevention has any harmful effects. However, research is ongoing regarding potential effects of ingested fluoride on human neurodevelopment and endocrine dysfunction. Simultaneously, research has emerged highlighting the significance of the human microbiome in gastrointestinal and immune health. In this review we evaluate the literature examining the effect of fluoride exposure on the human microbiome. Unfortunately, none of the studies retrieved examined the effects of ingested fluoridated water on the human microbiome. Animal studies generally examined acute fluoride toxicity following ingestion of fluoridated food and water and conclude that fluoride exposure can detrimentally perturb the normal microbiome. These data are difficult to extrapolate to physiologically relevant human exposure dose ranges and the significance to humans living in areas with CWF requires further investigation. Conversely, evidence suggests that the use of fluoride containing oral hygiene products may have beneficial effects on the oral microbiome regarding caries prevention. Overall, while fluoride exposure does appear to impact the human and animal microbiome, the long-term consequences of this requires further study.
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Affiliation(s)
- Gary P Moran
- School of Dental Science Trinity College Dublin and Dublin Dental University Hospital, Dublin 2, Republic of Ireland.
| | - Lina Zgaga
- Department of Public Health and Primary Care, School of Medicine, Trinity College Dublin, Dublin 24, Republic of Ireland
| | - Blánaid Daly
- School of Dental Science Trinity College Dublin and Dublin Dental University Hospital, Dublin 2, Republic of Ireland
| | - Mairead Harding
- Oral Health Services Research Centre, University College Cork, Cork, Republic of Ireland
| | - Therese Montgomery
- Department of Analytical, Biopharmaceutical and Medical Sciences, Atlantic Technological University (ATU) Galway, Galway, Republic of Ireland
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Zhang Q, Guan L, Guo J, Chuan A, Tong J, Ban J, Tian T, Jiang W, Wang S. Application of fluoride disturbs plaque microecology and promotes remineralization of enamel initial caries. J Oral Microbiol 2022; 14:2105022. [PMID: 35923900 PMCID: PMC9341347 DOI: 10.1080/20002297.2022.2105022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The caries-preventive effect of topical fluoride application has been corroborated by a number of clinical studies. However, the effect of fluoride on oral microecology remains unclear. Objective To monitor the effect of fluoride on dental plaque microecology and demineralization/remineralization balance of enamel initial caries. Methods Three-year-old children were enrolled and treated with fluoride at baseline and 6 months. International Caries Detection and Assessment System II indices of 52 subjects were measured at baseline, 3, 6, and 12 months. Supragingival plaque samples of 12 subjects were collected at baseline, 3 and 14 days for 16S rRNA sequencing. Results Changes in microbial community structure were observed at 3 days after fluoridation. Significant changes in the relative abundance of microorganisms were observed after fluoride application, especially Capnocytophaga, unidentified Prevotellaceae and Rothia. Functional prediction revealed that cell movement, carbohydrate and energy metabolism were affected significantly after fluoride application. Fluoride significantly inhibited enamel demineralization and promoted remineralization of early demineralized caries enamel at 3 months. Conclusion Fluoride application significantly inhibited the progression of enamel initial caries and reversed the demineralization process, possibly by disturbing dental plaque microecology and modulating the physicochemical action of demineralization/remineralization. This deepened our understanding of caries-preventive effects and mechanisms of fluoride.
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Affiliation(s)
- Qianxia Zhang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, School of Stomatology, the Fourth Military Medical University, Xi’an, PR China
| | - Lingxia Guan
- Department of Preventive Dentistry, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Jing Guo
- Department of Preventive Dentistry, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Aiyun Chuan
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, School of Stomatology, the Fourth Military Medical University, Xi’an, PR China
| | - Juan Tong
- Department of Preventive Dentistry, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Jinghao Ban
- Department of Preventive Dentistry, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Tian Tian
- Department of VIP Dental Care, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, School of Stomatology, The Fourth Military Medical University, Xi’an, PR China
| | - Wenkai Jiang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, School of Stomatology, the Fourth Military Medical University, Xi’an, PR China
| | - Shengchao Wang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, School of Stomatology, the Fourth Military Medical University, Xi’an, PR China
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Seriwatanachai D, Triratana T, Kraivaphan P, Amaornchat C, Mateo LR, Sabharwal A, Delgado E, Szewczyk G, Ryan M, Zhang YP. Effect of stannous fluoride and zinc phosphate dentifrice on dental plaque and gingivitis: A randomized clinical trial with 6-month follow-up. J Am Dent Assoc 2019; 150:S25-S31. [PMID: 30797256 DOI: 10.1016/j.adaj.2019.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/03/2019] [Accepted: 01/05/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study was to compare a stabilized stannous fluoride (SnF2) dentifrice with zinc phosphate (Colgate TotalSF) with SnF2 with zinc lactate and control fluoride dentifrices for gingivitis and plaque control over a 6-month period. METHODS A total of 135 adult participants were enrolled in this study. After randomization and blinding of examiners and patients, enrolled participants were provided instructions for use of assigned dentifrice. At 3 visits (0, 3, and 6 months), various gingival and plaque indexes were collected to determine the clinical efficacy of a stabilized SnF2 dentifrice. These results were compared with a SnF2 with zinc lactate dentifrice and with a control fluoride dentifrice. RESULTS A total of 135 participants completed the study. All groups reported statistically significant reductions in gingival inflammation and improvement in plaque control at 3- and 6-month follow-up. Both SnF2 dentifrices showed statistically significant reductions in all indexes compared with the control dentifrice (P < .001). However, the test dentifrice showed higher but nonsignificant improvements in plaque and gingival indexes compared with the other SnF2 dentifrice. CONCLUSIONS This study reports similar efficacy of a test dentifrice to a commercial SnF2-containing dentifrice for plaque control and reduction in gingival inflammation and provides supporting evidence that the test dentifrice maintains its clinical efficacy with change of formulation. PRACTICAL IMPLICATIONS This newly formulated SnF2 stabilized with zinc phosphate dentifrice may be of benefit to patients in controlling plaque biofilm and gingivitis.
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Hu D, Li X, Liu H, Mateo LR, Sabharwal A, Xu G, Szewczyk G, Ryan M, Zhang YP. Evaluation of a stabilized stannous fluoride dentifrice on dental plaque and gingivitis in a randomized controlled trial with 6-month follow-up. J Am Dent Assoc 2019; 150:S32-S37. [PMID: 30797257 DOI: 10.1016/j.adaj.2019.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/02/2019] [Accepted: 01/05/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The objective of this study was to compare a stannous fluoride (SnF2) dentifrice (Colgate TotalSF) stabilized with zinc phosphate with a sodium fluoride control dentifrice for gingivitis and plaque control over a 6-month period. METHODS One hundred adult participants were enrolled in this study conducted in Chengdu, China. After random assignment and blinding of examiners and patients, enrolled participants received instructions for use of the assigned dentifrice. At 3 visits (baseline and 3 and 6 months), the authors measured various gingival and plaque indexes to determine the clinical efficacy of the stabilized SnF2 dentifrice compared with those of the control fluoride dentifrice (2 groups). RESULTS Ninety-eight participants completed the study. Both groups (test and control) had statistically significant reductions in gingival inflammation and improvement in plaque control at the 3- and 6-month follow-ups. In addition, the test dentifrice showed statistically significant reductions in all indexes compared with the control dentifrice (P < .001). CONCLUSIONS This study's results show statistically significantly improved clinical outcomes for reduction of gingival inflammation and improvement in biofilm control over a 6-month period through the use of a SnF2 dentifrice stabilized with zinc phosphate when compared with results with a fluoride control dentifrice. PRACTICAL IMPLICATIONS This newly formulated dentifrice improves gingival health and plaque control and thereby may aid patients in attaining improved oral health.
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Wolff D, Frese C, Schoilew K, Dalpke A, Wolff B, Boutin S. Amplicon-based microbiome study highlights the loss of diversity and the establishment of a set of species in patients with dentin caries. PLoS One 2019; 14:e0219714. [PMID: 31365560 PMCID: PMC6668773 DOI: 10.1371/journal.pone.0219714] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/28/2019] [Indexed: 12/13/2022] Open
Abstract
Objectives To elicit patterns in pathogenic biofilm composition we characterized the oral microbiome present in patients with dentin caries in comparison to healthy subjects. Methods 16S amplicon sequencing was used to analyse a total of 56 patients; 19 samples of carious dentin (pooled from at least three teeth) and 37 supragingival samples (pooled from three healthy tooth surfaces). Oral and periodontal status and socio-demographic parameters were recorded. Group assignment, smoking and further socio-demographic parameters were used as explanatory variables in the microbiome composition analysis. Results Overall, a total of 4,110,020 DNA high-quality sequences were yielded. Using a threshold of similarity >97% for assigning operational taxonomic units (OTU), a total of 1,537 OTUs were identified. PERMANOVA showed significant differences in microbiome composition between the groups caries/healthy (p = 0.001), smoking/non-smoking (p = 0.007) and fluoride intake during childhood yes/no (tablets p = 0.003, salt p = 0.023). The healthy microbiome had a significantly higher diversity (alpha diversity, p<0.001) and a lower dominance (Berger-Parker index, p<0.001). It was dominated by Fusobacteria. A linear discriminant analysis effect size (LEfSe) yielded a set of 39 OTUs being more abundant in carious dentin samples, including Atopobium spp. (14.9 log2FoldChange), Lactobacillus casei (11.6), Acinetobacter spp. (10.8), Lactobacillus gasseri (10.6), Parascardovia denticolens (10.5), Olsenella profusa (10.4), and others. Also Propionibacterium acidifaciens (7.2) and Streptococcus mutans (5.2) were overabundant in caries lesions. Conclusions The healthy microbiome was highly diverse. The advanced caries microbiome was dominated by a set of carious associated bacteria where S. mutans played only a minor role. Smoking and fluoride intake during childhood influenced the microbiome composition significantly. Clinical significance The presented investigation adds knowledge to the still not fully comprehended patterns of oral microbiomes in caries compared with oral health. By analysing the genetics of biofilm samples from oral health and severe tooth decay we found distinct discriminating species which could be targets for future therapeutic approaches.
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Affiliation(s)
- Diana Wolff
- Department of Conservative Dentistry, Centre of Dentistry, Oral Medicine and Maxillofacial Surgery, University of Tuebingen, Tuebingen, Germany
- * E-mail:
| | - Cornelia Frese
- Department of Conservative Dentistry, School of Dental Medicine, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Kyrill Schoilew
- Department of Conservative Dentistry, School of Dental Medicine, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Alexander Dalpke
- Medical Microbiology and Hygiene, Technical University Dresden, Dresden, Germany
| | - Bjoern Wolff
- Department of Conservative Dentistry, School of Dental Medicine, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Sébastien Boutin
- Department of Infectious Diseases-Medical Microbiology and Hygiene, University Hospital Heidelberg, Heidelberg, Germany
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Philip N, Leishman SJ, Bandara HMHN, Healey DL, Walsh LJ. Randomized Controlled Study to Evaluate Microbial Ecological Effects of CPP-ACP and Cranberry on Dental Plaque. JDR Clin Trans Res 2019; 5:118-126. [PMID: 31283892 DOI: 10.1177/2380084419859871] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Ecological approaches to dental caries prevention play a key role in attaining long-term control over the disease and maintaining a symbiotic oral microbiome. OBJECTIVES This study aimed to investigate the microbial ecological effects of 2 interventional dentifrices: a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) dentifrice and the same dentifrice supplemented with a polyphenol-rich cranberry extract. METHODS The interventional toothpastes were compared with each other and with an active control fluoride dentifrice in a double-blinded randomized controlled trial. Real-time quantitative polymerase chain reaction (qPCR) analysis was used to determine changes in the bacterial loads of 14 key bacterial species (8 caries associated and 6 health associated) in the dental plaque of trial participants after they used the dentifrices for 5 to 6 wk. RESULTS From the baseline to the recall visit, significant differences were observed between the treatment groups in the bacterial loads of 2 caries-associated bacterial species (Streptococcus mutans [P < 0.001] and Veillonella parvula [P < 0.001]) and 3 health-associated bacterial species (Corynebacterium durum [P = 0.008], Neisseria flavescens [P = 0.005], and Streptococcus sanguinis [P < 0.001]). Compared to the fluoride control dentifrice, the CPP-ACP dentifrice demonstrated significant differences for S. mutans (P = 0.032), C. durum (P = 0.007), and S. sanguinis (P < 0.001), while combination CPP-ACP-cranberry dentifrice showed significant differences for S. mutans (P < 0.001), V. parvula (P < 0.001), N. flavescens (P = 0.003), and S. sanguinis (P < 0.001). However, no significant differences were observed in the bacterial load comparisons between the CPP-ACP and combination dentifrices for any of the targeted bacterial species (P > 0.05). CONCLUSIONS Overall, the results indicate that dentifrices containing CPP-ACP and polyphenol-rich cranberry extracts can influence a species-level shift in the ecology of the oral microbiome, resulting in a microbial community less associated with dental caries (Australian New Zealand Clinical Trial Registry ANZCTR 12618000095268). KNOWLEDGE TRANSFER STATEMENT The results of this randomized controlled trial indicate that dentifrices containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and polyphenol-rich cranberry extracts were able to beneficially modulate the microbial ecology of dental plaque in a group of high caries-risk patients. This could contribute toward lowering the risk of developing new caries lesions, an important goal sought by patients, clinicians, and policy makers.
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Affiliation(s)
- N Philip
- The University of Queensland School of Dentistry, Brisbane, Australia
| | - S J Leishman
- The University of Queensland School of Dentistry, Brisbane, Australia
| | | | - D L Healey
- The University of Queensland School of Dentistry, Brisbane, Australia
| | - L J Walsh
- The University of Queensland School of Dentistry, Brisbane, Australia
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Philip N, Leishman SJ, Bandara HMHN, Walsh LJ. Casein Phosphopeptide-Amorphous Calcium Phosphate Attenuates Virulence and Modulates Microbial Ecology of Saliva-Derived Polymicrobial Biofilms. Caries Res 2019; 53:643-649. [PMID: 31163430 DOI: 10.1159/000499869] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/25/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) acts as a salivary biomimetic that provides bioavailable calcium and phosphate ions to augment fluoride-mediated remineralisation of early caries lesions. However, there are indications that it may also have beneficial ecological effects on the oral microbiome. OBJECTIVE This in vitro study investigated whether CPP-ACP could influence microbial counts, acidogenicity, and the relative abundance of specific caries- and health-associated bacterial -species in polymicrobial biofilms. METHODS Saliva-derived polymicrobial biofilms were grown for 96 h in a cariogenic environment and treated every 12 h with 2% CPP-ACP or vehicle control. Colony forming units (CFUs) and acidogenicity were estimated from the treated biofilms. Microbial ecological effects of CPP-ACP were assessed based on the relative abundance of 14 specific caries- and health-associated -bacterial species using a real-time quantitative PCR assay. -Results: CPP-ACP-treated biofilms showed relatively modest, but significant, reductions in microbial CFUs (21% reduction, p = 0.008) and acidogenicity (33% reduction, p < 0.001), compared to the control-treated biofilms. The CPP-ACP treated biofilms also exhibited significantly lower bacterial loads of cariogenic Scardovia wiggsiae (fold change 0.017, p < 0.001) and Prevotella denticola(fold change 0.005, p < 0.001), and higher bacterial loads of commensal Streptococcus sanguinis(fold change 30.22, p < 0.001), S. mitis/oralis(fold change 9.66, p = 0.012), and S. salivarius/thermophilus(fold change 89.35, p < 0.001) than the control-treated biofilms. CONCLUSIONS The results indicate that CPP-ACP has virulence-attenuating attributes that can influence a beneficial microbial ecological change in the biofilm.
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Affiliation(s)
- Nebu Philip
- The University of Queensland School of Dentistry, Brisbane, Queensland, Australia,
| | - Shaneen J Leishman
- The University of Queensland School of Dentistry, Brisbane, Queensland, Australia
| | - H M H N Bandara
- Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Laurence J Walsh
- The University of Queensland School of Dentistry, Brisbane, Queensland, Australia
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Luo TL, Hayashi M, Zsiska M, Circello B, Eisenberg M, Gonzalez-Cabezas C, Foxman B, Marrs CF, Rickard AH. Introducing BAIT (Biofilm Architecture Inference Tool): a software program to evaluate the architecture of oral multi-species biofilms. MICROBIOLOGY (READING, ENGLAND) 2019; 165:527-537. [PMID: 30882296 DOI: 10.1099/mic.0.000761] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Biofilm model systems are used to study biofilm growth and predict the effects of anti-biofilm interventions within the human oral cavity. Many in vitro biofilm model systems use a confocal laser scanning microscope (CLSM) in conjunction with image analysis tools to study biofilms. The aim of this study was to evaluate an in-house developed image analysis software program that we call BAIT (Biofilm Architecture Inference Tool) to quantify the architecture of oral multi-species biofilms following anti-biofilm interventions using a microfluidic biofilm system. Differences in architecture were compared between untreated biofilms and those treated with water (negative control), sodium gluconate ('placebo') or stannous fluoride (SnF2). The microfluidic system was inoculated with pooled human saliva and biofilms were developed over 22 h in filter-sterilized 25 % pooled human saliva. During this period, biofilms were treated with water, sodium gluconate, or SnF2 (1000, 3439 or 10 000 p.p.m. Sn2+) 8 and 18 h post-inoculation. After 22 h of growth, biofilms were stained with LIVE/DEAD stain, and imaged by CLSM. BAIT was used to calculate biofilm biovolume, total number of objects, surface area, fluffiness, connectivity, convex hull porosity and viability. Image analysis showed oral biofilm architecture was significantly altered by 3439 and 10 000 p.p.m. Sn2+ treatment regimens, resulting in decreased biovolume, surface area, number of objects and connectivity, while fluffiness increased (P<0.01). In conclusion, BAIT was shown to be able to measure the changes in biofilm architecture and detects possible antimicrobial and anti-biofilm effects of candidate agents.
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Affiliation(s)
- Ting L Luo
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Michael Hayashi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | | | - Marisa Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Carlos Gonzalez-Cabezas
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Betsy Foxman
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Carl F Marrs
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Alexander H Rickard
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Moussa DG, Fok A, Aparicio C. Hydrophobic and antimicrobial dentin: A peptide-based 2-tier protective system for dental resin composite restorations. Acta Biomater 2019; 88:251-265. [PMID: 30753942 PMCID: PMC6474255 DOI: 10.1016/j.actbio.2019.02.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/09/2019] [Accepted: 02/08/2019] [Indexed: 12/12/2022]
Abstract
Dental caries, i.e., tooth decay mediated by bacterial activity, is the most widespread chronic disease worldwide. Carious lesions are commonly treated using dental resin composite restorations. However, resin composite restorations are prone to recurrent caries, i.e., reinfection of the surrounding dental hard tissues. Recurrent caries is mainly a consequence of waterborne and/or biofilm-mediated degradation of the tooth-restoration interface through hydrolytic, acidic and/or enzymatic challenges. Here we use amphipathic antimicrobial peptides to directly coat dentin to provide resin composite restorations with a 2-tier protective system, simultaneously exploiting the physicochemical and biological properties of these peptides. Our peptide coatings modulate dentin's hydrophobicity, impermeabilize it, and are active against multispecies biofilms derived from caries-active individuals. Therefore, the coatings hinder water penetration along the otherwise vulnerable dentin/restoration interface, even after in vitro aging, and increase its resistance against degradation by water, acids, and saliva. Moreover, they do not weaken the resin composite restorations mechanically. The peptide-coated highly-hydrophobic dentin is expected to notably improve the service life of resin composite restorations and to enable the development of entirely hydrophobic restorative systems. The peptide coatings were also antimicrobial and thus, they provide a second tier of protection preventing re-infection of tissues in contact with restorations. STATEMENT OF SIGNIFICANCE: We present a technology using designer peptides to treat the most prevalent chronic disease worldwide; dental caries. Specifically, we used antimicrobial amphipathic peptides to coat dentin with the goal of increasing the service life of the restorative materials used to treat dental caries, which is nowadays 5 years on average. Water and waterborne agents (enzymes, acids) degrade restorative materials and enable re-infection at the dentin/restoration interface. Our peptide coatings will hinder degradation of the restoration as they produced highly hydrophobic and antimicrobial dentin/material interfaces. We anticipate a high technological and economic impact of our technology as it can notably reduce the lifelong dental bill of patients worldwide. Our findings can enable the development of restorations with all-hydrophobic and so, more protective components.
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Affiliation(s)
- Dina G Moussa
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Alex Fok
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Conrado Aparicio
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
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Fernández C, Aspiras M, Dodds M, González-Cabezas C, Rickard A. The effect of inoculum source and fluid shear force on the development ofin vitrooral multispecies biofilms. J Appl Microbiol 2017; 122:796-808. [DOI: 10.1111/jam.13376] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 12/23/2022]
Affiliation(s)
- C.E. Fernández
- Department of Epidemiology; School of Public Health; University of Michigan; Ann Arbor MI USA
- Department of Cariology; Restorative Sciences and Endodontics; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - M.B. Aspiras
- Scientific Discovery; Global Innovation Center (GIC); Wrigley; Chicago IL USA
| | - M.W. Dodds
- Scientific Discovery; Global Innovation Center (GIC); Wrigley; Chicago IL USA
| | - C. González-Cabezas
- Department of Cariology; Restorative Sciences and Endodontics; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - A.H. Rickard
- Department of Epidemiology; School of Public Health; University of Michigan; Ann Arbor MI USA
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13
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Cheng X, Liu J, Li J, Zhou X, Wang L, Liu J, Xu X. Comparative effect of a stannous fluoride toothpaste and a sodium fluoride toothpaste on a multispecies biofilm. Arch Oral Biol 2017; 74:5-11. [DOI: 10.1016/j.archoralbio.2016.10.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/16/2016] [Accepted: 10/25/2016] [Indexed: 02/06/2023]
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Reilly C, Goettl M, Steinmetz M, Nikrad J, Jones RS. Short-term effects of povidone iodine and sodium fluoride therapy on plaque levels and microbiome diversity. Oral Dis 2016; 22:155-61. [DOI: 10.1111/odi.12407] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/02/2015] [Accepted: 11/25/2015] [Indexed: 01/10/2023]
Affiliation(s)
- C Reilly
- Division of Biostatistics; School of Public Health; University of Minnesota; Minneapolis MN USA
| | - M Goettl
- Division of Pediatric Dentistry; Department of Developmental and Surgical Sciences; School of Dentistry; University of Minnesota; Minneapolis MN USA
| | - M Steinmetz
- Division of Pediatric Dentistry; Department of Developmental and Surgical Sciences; School of Dentistry; University of Minnesota; Minneapolis MN USA
| | - J Nikrad
- Division of Pediatric Dentistry; Department of Developmental and Surgical Sciences; School of Dentistry; University of Minnesota; Minneapolis MN USA
| | - RS Jones
- Division of Pediatric Dentistry; Department of Developmental and Surgical Sciences; School of Dentistry; University of Minnesota; Minneapolis MN USA
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15
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Rasmussen K, Nikrad J, Reilly C, Li Y, Jones RS. N-Acetyl-l-cysteine effects on multi-species oral biofilm formation and bacterial ecology. Lett Appl Microbiol 2015; 62:30-8. [PMID: 26518358 DOI: 10.1111/lam.12513] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/15/2015] [Accepted: 10/16/2015] [Indexed: 11/27/2022]
Abstract
UNLABELLED Future therapies for the treatment of dental decay have to consider the importance of preserving bacterial ecology while reducing biofilm adherence to teeth. A multi-species plaque-derived (MSPD) biofilm model was used to assess how concentrations of N-acetyl-l-cysteine (NAC) (0, 0·1, 1, 10%) affected the growth of complex oral biofilms. Biofilms were grown (n = 96) for 24 h on hydroxyapatite discs in BMM media with 0·5% sucrose. Bacterial viability and biomass formation was examined on each disc using a microtitre plate reader. In addition, fluorescence microscopy and Scanning Electron Microscopy was used to qualitatively examine the effect of NAC on bacterial biofilm aggregation, extracellular components and bacterial morphology. The total biomass was significantly decreased after exposure of both 1% (from 0·48, with a 95% confidence interval of (0·44, 0·57) to 0·35, with confidence interval (0·31, 0·38)) and 10% NAC (0·14 with confidence interval (0·11, 0·17)). 16S rRNA amplicon sequencing analysis indicated that 1% NAC reduced biofilm adherence while preserving biofilm ecology. SIGNIFICANCE AND IMPACT OF THE STUDY As a compound with a wide safety margin, N-acetyl-l-cysteine (NAC) has the potential to be used as a long term anti-plaque bacteriostatic agent for managing chronic dental decay without substantially altering biofilm's bacterial ecology. The potential anti-caries benefit of NAC is directly related to reducing the biofilm coverage which reduces the degree of acid generation and the amount of time that the surface is exposed to a lower pH.
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Affiliation(s)
- K Rasmussen
- Division of Pediatric Dentistry, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - J Nikrad
- Division of Pediatric Dentistry, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - C Reilly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Y Li
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - R S Jones
- Division of Pediatric Dentistry, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
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Rasmussen K, Reilly C, Li Y, Jones RS. Real-time imaging of anti-biofilm effects using CP-OCT. Biotechnol Bioeng 2015; 113:198-205. [PMID: 26156808 DOI: 10.1002/bit.25701] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/16/2015] [Accepted: 07/03/2015] [Indexed: 11/06/2022]
Abstract
The objective of this study was to develop a method to reliably and reproducibly assess the physical properties of in vitro multi-species plaque derived biofilms. A custom flow cell (FC) was designed to model oral cavity shear stresses on biofilms grown on hydroxyapatite (HA) discs. A finite-element program (ANSYS 13) modeled flow velocities and wall shear stresses on the interior 3D dimensions. For the experiment, 1% chlorhexidine (CHX), 5 M urea, and a 1× phosphate-buffered saline (PBS) were flown through the FC simulating oral rinsing. Near infrared cross-polarization optical coherence tomography (CP-OCT) non-destructively imaged the fluid immersed biofilms in real time (20 frames/s). During low flow, the swell of the biofilm caused from 5 M urea was quite pronounced increase in vertical dimension. Biofilms exposed to 1% CHX showed a slight collapse in the vertical dimension of the biofilm during low flow. During high flow/high sheer stress, the 5 M urea solution effectively removed the biofilm, while both 1% CHX and 1× PBS did not remove biofilms even under high velocity/shear stress conditions.
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Affiliation(s)
- Karin Rasmussen
- Department of Developmental and Surgical Sciences, Division of Pediatric Dentistry, School of Dentistry, University of Minnesota, 6-150C Moos Tower, 515 Delaware St. SE, Minneapolis, 55455, Minnesota
| | - Cavan Reilly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Yuping Li
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, Minnesota
| | - Robert S Jones
- Department of Developmental and Surgical Sciences, Division of Pediatric Dentistry, School of Dentistry, University of Minnesota, 6-150C Moos Tower, 515 Delaware St. SE, Minneapolis, 55455, Minnesota.
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