Reduction of Streptococcus mutans adherence and dental biofilm formation by surface treatment with phosphorylated polyethylene glycol

Effects of a new chlorhexidine varnish on Streptococcus mutans biofilm formation in vitro

Background

Local sustained-release drug delivery systems increase the substantivity of drugs in the oral environment and subsequently enhance their therapeutic effects. This study sought to compare the effects of two commercially available varnishes and one experimental chlorhexidine (CHX) varnish on formation of Streptococcus mutans biofilm. The solubility rates of the varnishes were evaluated as well.

Methods

Standard acrylic discs were fabricated and divided into groups based on the varnish applied to the disc surfaces, namely, V-varnish, Pascal, and experimental CHX varnish. The effects of the varnishes on S. mutans biofilm were assessed after 48 h. Bacterial growth on the discs was evaluated by colony count and scanning electron microscopy (SEM). Solubility was assessed by immersing the samples in phosphate buffered saline and recording their weight changes at different times. The data were analyzed using one-way ANOVA.

Results

In the Pascal and experimental varnish groups, the total number of bacteria did not differ from that in the negative control group. The SEM findings confirmed the aforementioned results. Solubility varied significantly among the materials. V-varnish was detached from the surfaces after 2 days. No significant weight change was noted in the experimental varnish group at 14 days, while Pascal varnish showed gradual weight loss from the 5th day to the 10th day and had a plateau thereafter.

Conclusions

Biofilm formation was inhibited by the Pascal and experimental varnishes but not by the V-varnish. The highest acceptable rate of solubility was observed in the Pascal samples.

Biological and Mechanical Evaluation of Novel Prototype Dental Composites

The breakdown of the polymeric component of contemporary composite dental restorative materials compromises their longevity, while leachable compounds from these materials have cellular consequences. Thus, a new generation of composite materials needed to be designed to have a longer service life and ensure that any leachable compounds are not harmful to appropriate cell lines. To accomplish this, we have developed concurrent thiol-ene-based polymerization and allyl sulfide-based addition-fragmentation chain transfer chemistries to afford cross-linked polymeric resins that demonstrate low shrinkage and low shrinkage stress. In the past, the filler used in dental composites mainly consisted of glass, which is biologically inert. In several of our prototype composites, we introduced fluorapatite (FA) crystals, which resemble enamel crystals and are bioactive. These novel prototype composites were benchmarked against similarly filled methacrylate-based bisphenol A diglycidyl ether dimethacrylate / triethylene glycol dimethacrylate (bisGMA/TEGDMA) composite for their cytotoxicity, mechanical properties, biofilm formation, and fluoride release. The leachables at pH 7 from all the composites were nontoxic to dental pulp stem cells. There was a trend toward an increase in total toughness of the glass-only-filled prototype composites as compared with the similarly filled bisGMA/TEGDMA composite. Other mechanical properties of the glass-only-filled prototype composites were comparable to the similarly filled bisGMA/TEGDMA composite. Incorporation of the FA reduced the mechanical properties of the prototype and bisGMA/TEGDMA composite. Biofilm mass and colony-forming units per milliliter were reduced on the glass-only-filled prototype composites as compared with the glass-only-filled bisGMA/TEGDMA composite and were significantly reduced by the addition of FA to all composites. Fluoride release at pH 7 was greatest after 24 h for the bisGMA/TEGDMA glass + FA composite as compared with the similarly filled prototypes, but overall the F^- release was marginal and not at a concentration to affect bacterial metabolism.

Streptococcal adhesin SspA/B analogue peptide inhibits adherence and impacts biofilm formation of Streptococcus mutans

Streptococcus mutans, the major causative agent of dental caries, adheres to tooth surfaces via the host salivary glycoprotein-340 (gp340). This adherence can be competitively inhibited by peptides derived from the SspA/B adhesins of Streptococcus gordonii, a human commensal microbe that competes for the same binding sites. Ssp(A4K-A11K), a double-lysine substituted SspA/B peptide analogue, has been shown to exhibit superior in vitro binding affinity for a gp340-derived peptide (SRCRP2), suggesting that Ssp(A4K-A11K) may be of clinical interest. In the present work, we tested the inhibitory effects of Ssp(A4K-A11K) on adherence and biofilm formation of S. mutans by reconstructing an artificial oral environment using saliva-coated polystyrene plates and hydroxyapatite disks. Bacterial adherence (adherence period: 1 h) was assessed by an enzyme-linked immunosorbent assay using biotinylated bacterial cells. Biofilm formation (periods: 8, 11, or 14 h) was assessed by staining and imaging of the sessile cells, or by recovering biofilm cells and plating for cell counts. The pH values of the culture media were measured as a biofilm acidogenicity indicator. Bactericidality was measured by loss of optical density during culturing in the presence of the peptide. We observed that 650 μM Ssp(A4K-A11K) significantly inhibited adherence of S. mutans to saliva-coated polystyrene; a similar effect was seen on bacterial affinity for SRCRP2. Ssp(A4K-A11K) had lesser effects on the adherence of commensal streptococci. Pretreatment of polystyrene and hydroxyapatite with 650 μM Ssp(A4K-A11K) significantly attenuated biofilm formation, whether tested with glucose- or sucrose-containing media. The SspA/B peptide’s activity did not reflect bactericidality. Strikingly, pH in Ssp-treated 8-h (6.8 ± 0.06) and 11-h (5.5 ± 0.06) biofilms showed higher values than the critical pH. Thus, Ssp(A4K-A11K) acts by inhibiting bacterial adherence and cariogrnic biofilm formation. We further consider these results in the context of the safety, specificity, and stability properties of the Ssp(A4K-A11K) peptide.

Inhibition of Cariogenic Plaque Formation on Root Surface with Polydopamine-Induced-Polyethylene Glycol Coating

Root caries prevention has been a challenge for clinicians due to its special anatomical location, which favors the accumulation of dental plaque. Researchers are looking for anti-biofouling material to inhibit bacterial growth on exposed root surfaces. This study aimed to develop polydopamine-induced-polyethylene glycol (PEG) and to study its anti-biofouling effect against a multi-species cariogenic biofilm on the root dentine surface. Hydroxyapatite disks and human dentine blocks were divided into four groups for experiments. They received polydopamine-induced-PEG, PEG, polydopamine, or water application. Contact angle, quartz crystal microbalance, and Fourier transform infrared spectroscopy were used to study the wetting property, surface affinity, and an infrared spectrum; the results indicated that PEG was induced by polydopamine onto a hydroxyapatite disk. Salivary mucin absorption on hydroxyapatite disks with polydopamine-induced-PEG was confirmed using spectrophotometry. The growth of a multi-species cariogenic biofilm on dentine blocks with polydopamine-induced-PEG was assessed and monitored by colony-forming units, confocal laser scanning microscopy, and scanning electron microscopy. The results showed that dentine with polydopamine-induced-PEG had fewer bacteria than other groups. In conclusion, a novel polydopamine-induced-PEG coating was developed. Its anti-biofouling effect inhibited salivary mucin absorption and cariogenic biofilm formation on dentine surface and thus may be used for the prevention of root dentine caries.

Self-cleaning and antibiofouling enamel surface by slippery liquid-infused technique

We aimed to create a slippery liquid-infused enamel surface with antibiofouling property to prevent dental biofilm/plaque formation. First, a micro/nanoporous enamel surface was obtained by 37% phosphoric acid etching. The surface was then functionalized by hydrophobic low-surface energy heptadecafluoro-1,1,2,2-tetra- hydrodecyltrichlorosilane. Subsequent infusion of fluorocarbon lubricants (Fluorinert FC-70) into the polyfluoroalkyl-silanized rough surface resulted in an enamel surface with slippery liquid-infused porous surface (SLIPS). The results of water contact angle measurement, diffuse-reflectance Fourier transform infrared spectroscopy, and atomic force microscope confirmed that the SLIPS was successfully constructed on the enamel surface. The antibiofouling property of the SLIPS was evaluated by the adsorption of salivary protein of mucin and Streptococcus mutans in vitro, as well as dental biofilm formation using a rabbit model in vivo. The results showed that the SLIPS on the enamel surface significantly inhibited mucin adhesion and S. mutans biofilm formation in vitro, and inhibited dental plaque formation in vivo.

Chimeric peptides as implant functionalization agents for titanium alloy implants with antimicrobial properties

Implant-associated infections can have severe effects on the longevity of implant devices and they also represent a major cause of implant failures. Treating these infections associated with implants by antibiotics is not always an effective strategy due to poor penetration rates of antibiotics into biofilms. Additionally, emerging antibiotic resistance poses serious concerns. There is an urge to develop effective antibacterial surfaces that prevent bacterial adhesion and proliferation. A novel class of bacterial therapeutic agents, known as antimicrobial peptides (AMP's), are receiving increasing attention as an unconventional option to treat septic infection, partly due to their capacity to stimulate innate immune responses and for the difficulty of microorganisms to develop resistance towards them. While host- and bacterial- cells compete in determining the ultimate fate of the implant, functionalization of implant surfaces with antimicrobial peptides can shift the balance and prevent implant infections. In the present study, we developed a novel chimeric peptide to functionalize the implant material surface. The chimeric peptide simultaneously presents two functionalities, with one domain binding to a titanium alloy implant surface through a titanium-binding domain while the other domain displays an antimicrobial property. This approach gains strength through control over the bio-material interfaces, a property built upon molecular recognition and self-assembly through a titanium alloy binding domain in the chimeric peptide. The efficiency of chimeric peptide both in-solution and absorbed onto titanium alloy surface was evaluated in vitro against three common human host infectious bacteria, S. mutans, S. epidermidis, and E. coli. In biological interactions such as occurs on implants, it is the surface and the interface that dictate the ultimate outcome. Controlling the implant surface by creating an interface composed chimeric peptides may therefore open up new possibilities to cover the implant site and tailor it to a desirable bioactivity.

Poly(ethylene oxide)-based block copolymers with very high molecular weights for biomimetic calcium phosphate mineralization

Ampholytic and betaine-type block copolymers are excellent growth modifiers for calcium phosphate in biologically inspired calcium phosphate mineralization.

Inhibitory effects of children's toothpastes on Streptococcus mutans, Streptococcus sanguinis and Lactobacillus acidophilus

AIM

As suppression of Streptococcus mutans in young children may prevent or delay colonisation of the oral cavity, toothbrushing with dentifrices containing anti-S. mutans activity may aid in preventing caries. The aims of this study were to compare the effects of children's dentifrices on the growth of S. mutans and non-mutans bacteria (Streptococcus sanguinis and Lactobacillus acidophilus).

MATERIALS AND METHODS

The agar diffusion assay at neutral pH was used to examine the antibacterial activity of commercial dentifrices and their major constituents.

RESULTS

Dentifrices containing 1,450 ppm fluoride produced greater growth inhibition of both S. mutans and S. sanguinis than those with <500 ppm. No inhibition was seen for pure solutions of sodium fluoride or sodium monofluorophosphate at fluoride concentrations up to 100,000 ppm. Stannous fluoride exerted antibacterial effects at concentrations above 10,000 ppm. Significant growth inhibition of both S. mutans and S. sanguinis was seen with sodium lauryl sulphate at 2,500 ppm and with triclosan at 100 ppm. No inhibitory effects were seen for xylitol, sorbitol, sodium pyrophosphate or polyethylene glycol at concentrations up to 80,000 ppm.

CONCLUSION

Sodium lauryl sulphate is the major bacterial inhibitory compound in children's dentifrices.

Poly(ethylene oxide)-b-poly(3-sulfopropyl methacrylate) block copolymers for calcium phosphate mineralization and biofilm inhibition

Poly(ethylene oxide) (PEO) has long been used as an additive in toothpaste, partly because it reduces biofilm formation on teeth. It does not, however, reduce the formation of dental calculus or support the remineralization of dental enamel or dentine. The present article describes the synthesis of new block copolymers on the basis of PEO and poly(3-sulfopropyl methacrylate) blocks using atom transfer radical polymerization. The polymers have very large molecular weights (over 10(6) g/mol) and are highly water-soluble. They delay the precipitation of calcium phosphate from aqueous solution but, upon precipitation, lead to relatively monodisperse hydroxyapatite (HAP) spheres. Moreover, the polymers inhibit the bacterial colonization of human enamel by Streptococcus gordonii, a pioneer bacterium in oral biofilm formation, in vitro. The formation of well-defined HAP spheres suggests that a polymer-induced liquid precursor phase could be involved in the precipitation process. Moreover, the inhibition of bacterial adhesion suggests that the polymers could be utilized in caries prevention.

Proteins, pathogens, and failure at the composite-tooth interface

In the United States, composites accounted for nearly 70% of the 173.2 million composite and amalgam restorations placed in 2006 (Kingman et al., 2012), and it is likely that the use of composite will continue to increase as dentists phase out dental amalgam. This trend is not, however, without consequences. The failure rate of composite restorations is double that of amalgam (Ferracane, 2013). Composite restorations accumulate more biofilm, experience more secondary decay, and require more frequent replacement. In vivo biodegradation of the adhesive bond at the composite-tooth interface is a major contributor to the cascade of events leading to restoration failure. Binding by proteins, particularly gp340, from the salivary pellicle leads to biofilm attachment, which accelerates degradation of the interfacial bond and demineralization of the tooth by recruiting the pioneer bacterium Streptococcus mutans to the surface. Bacterial production of lactic acid lowers the pH of the oral microenvironment, erodes hydroxyapatite in enamel and dentin, and promotes hydrolysis of the adhesive. Secreted esterases further hydrolyze the adhesive polymer, exposing the soft underlying collagenous dentinal matrix and allowing further infiltration by the pathogenic biofilm. Manifold approaches are being pursued to increase the longevity of composite dental restorations based on the major contributing factors responsible for degradation. The key material and biological components and the interactions involved in the destructive processes, including recent advances in understanding the structural and molecular basis of biofilm recruitment, are described in this review. Innovative strategies to mitigate these pathogenic effects and slow deterioration are discussed.

The development of drug-free therapy for prevention of dental caries

PURPOSE

The purpose of this study was to develop a novel, drug-free therapy that can reduce the over-accumulation of cariogenic bacteria on dental surfaces.

METHODS

We designed and synthesized a polyethylene glycol (PEG)-based hydrophilic copolymer functionalized with a pyrophosphate (PPi) tooth-binding anchor using "click" chemistry. The polymer was then evaluated for hydroxyapatite (HA) binding kinetics and capability of reducing bacteria adhesion to artificial tooth surface.

RESULTS

The PPi-PEG copolymer can effectively inhibit salivary protein adsorption after rapid binding to an artificial tooth surface. As a result, the in vitro S. mutans adhesion study showed that the PPi-PEG copolymer can inhibit saliva protein-promoted S. mutans adhesion through the creation of a neutral, hydrophilic layer on the artificial tooth surface.

CONCLUSIONS

The results suggested the potential application of a PPi-PEG copolymer as a drug-free alternative to current antimicrobial therapy for caries prevention.

A review of the biomaterials technologies for infection-resistant surfaces

Anti-infective biomaterials need to be tailored according to the specific clinical application. All their properties have to be tuned to achieve the best anti-infective performance together with safe biocompatibility and appropriate tissue interactions. Innovative technologies are developing new biomaterials and surfaces endowed with anti-infective properties, relying either on antifouling, or bactericidal, or antibiofilm activities. This review aims at thoroughly surveying the numerous classes of antibacterial biomaterials and the underlying strategies behind them. Bacteria repelling and antiadhesive surfaces, materials with intrinsic antibacterial properties, antibacterial coatings, nanostructured materials, and molecules interfering with bacterial biofilm are considered. Among the new strategies, the use of phages or of antisense peptide nucleic acids are discussed, as well as the possibility to modulate the local immune response by active cytokines. Overall, there is a wealth of technical solutions to contrast the establishment of an implant infection. Many of them exhibit a great potential in preclinical models. The lack of well-structured prospective multicenter clinical trials hinders the achievement of conclusive data on the efficacy and comparative performance of anti-infective biomaterials.

A high-sensitive and non-radioisotopic fluorescence dye method for evaluating bacterial adhesion to denture materials

Oral bacteria adhered to dental material surfaces are known to cause various oral diseases. This study aimed to develop a highsensitive and non-radioisotopic fluorescence dye method for quantification of oral bacteria (Streptococcus, Actinomyces and Veillonella) adhered to denture material surfaces. The amount of adhered bacteria was estimated from the fluorescence intensity derived from resazurin, which is reduced by bacterial metabolic reactions. The addition of bacterial metabolic substrates (glucose for Streptococcus and Actinomyces and sodium lactate for Veillonella) to the reaction mixture increased the fluorescence intensity by 2.3-110 times, subsequently improved the sensitivity. Furthermore, an experimental device having silicon wells containing test material was carefully designed for accurate quantification of bacteria adhered to test materials. The improved resazurin method using a new experimental device successfully enabled the quantification of bacterial adhesion to polymethyl methacrylate and other three conventional denture materials.

Toward mucoadhesive hydrogel formulations for the management of xerostomia: the physicochemical, biological, and pharmacological considerations

Although hydrogel formulations that may be applied to many mucosal surfaces are now readily accessible, little research effort has been concentrated on the development of systems that may be usefully employed for the prolonged hydration of the oral cavity. To this end, and set within the context of oral care in general, this review considers the requirements for the design of hydrogel formulations with an affinity for buccal cells and details methods for evaluating the performance of these formulations as treatments for the management of xerostomia.

Effect of vegetable oil (Brazil nut oil) and mineral oil (liquid petrolatum) on dental biofilm control

Dental biofilm control represents a basic procedure to prevent caries and the occurrence of periodontal diseases. Currently, toothbrushes and dentifrices are used almost universally, and the employment of good oral hygiene allows for appropriate biofilm removal by both mechanical and chemical control. The aim of this study was to evaluate the effectiveness of adding vegetable or mineral oil to a commercially available dentifrice in dental biofilm control. A comparison using the Oral Hygiene Index Simplified (OHI-S) was performed in 30 individuals who were randomly divided into three groups. Group 1 (G1) received a commercially available dentifrice; the composition of this dentifrice was modified by addition of mineral oil (Nujol®) for group 2 (G2) or a vegetable oil (Alpha Care®) for group 3 (G3) at 10% of the total volume, respectively. The two-way repeated-measures analysis of variance (two-way ANOVA) was used to test the effect of group (G1, G2 and G3) or time (baseline, 45 days and 90 days) on the OHI-S index scores. Statistical analysis revealed a significant reduction in the OHI-S at day 90 in G2 (p < 0.05) and G3 (p < 0.0001) in comparison to G1. Therefore, the addition of a vegetable or a mineral oil to a commercially available dentifrice improved dental biofilm control, suggesting that these oils may aid in the prevention and/or control of caries and periodontal disease.

Biofilm formation in environmental bacteria is influenced by different macromolecules depending on genus and species

The formation of biofilms by diverse bacteria isolated from contaminated soil and groundwater on model substrata with different surface properties was assessed in a multifactorial screen. Diverse attachment phenotypes were observed as measured by crystal violet dye retention and confocal laser scanning microscopy (CLSM). Bulk measurements of cell hydrophobicity had little predictive ability in determining whether biofilms would develop on hydrophobic or hydrophilic substrata. Therefore selected pairs of bacteria from the genera Rhodococcus, Pseudomonas and Sphingomonas that exhibited different attachment phenotypes were examined in more detail using CLSM and the lipophilic dye, Nile Red. The association of Rhodococcus sp. cell membranes with lipids was shown to influence the attachment properties of these cells, but this approach was not informative for Pseudomonas and Sphingomonas sp. Confocal Raman Microspectroscopy of Rhodococcus biofilms confirmed the importance of lipids in their formation and indicated that in Pseudomonas and Sphingomonas biofilms, nucleic acids and proteins, respectively, were important in identifying the differences in attachment phenotypes of the selected strains. Treatment of biofilms with DNase I confirmed a determining role for nucleic acids as predicted for Pseudomonas. This work demonstrates that the attachment phenotypes of microbes from environmental samples to different substrata varies markedly, a diverse range of macromolecules may be involved and that these differ significantly between genera. A combination of CLSM and Raman spectroscopy distinguished between phenotypes and could be used to identify the key macromolecules involved in cell attachment to surfaces for the specific cases studied.