Direct and transdentinal (indirect) antibacterial activity of commercially available dental gel formulations against Streptococcus mutans

Synthesis, Antimicrobial Activities, and Molecular Modeling Studies of Agents for the Sortase A Enzyme

Sortase A (SrtA) is an attractive target for developing new anti-infective drugs that aim to interfere with essential virulence mechanisms, such as adhesion to host cells and biofilm formation. Herein, twenty hydroxy, nitro, bromo, fluoro, and methoxy substituted chalcone compounds were synthesized, antimicrobial activities and molecular modeling strategies against the SrtA enzyme were investigated. The most active compounds were found to be T2, T4, and T19 against Streptococcus mutans (S. mutans) with MIC values of 1.93, 3.8, 3.94 μg/mL, and docking scores of -6.46, -6.63, -6.73 kcal/mol, respectively. Also, these three active compounds showed better activity than the chlorohexidine (CHX) (MIC value: 4.88 μg/mL, docking score: -6.29 kcal/mol) in both in vitro and in silico. Structural stability and binding free energy analysis of S.mutans SrtA with active compounds were measured by molecular dynamic (MD) simulations throughout 100 nanoseconds (ns) time. It was observed that the stability of the critical interactions between these compounds and the target enzyme was preserved. To prove further, in vivo biological evaluation studies could be conducted for the most promising precursor compounds T2, T4, and T19, and it might open new avenues to the discovery of more potent SrtA inhibitors.

Effect of experimental dentin etchants on dentin bond strength, metalloproteinase inhibition, and antibiofilm activity

OBJECTIVE

this study evaluated dentin microtensile bond strength (µTBS) and failure modes (at 24 h and one year), bonding interface regarding hybridization, surface morphology regarding demineralization, in situ metalloproteinase (MMP) activity, and antibacterial effect of three dentin etchants compared to 35% phosphoric acid (PA).

MATERIALS AND METHODS

The Adper Single Bond 2 adhesive (3 M Oral Care) was applied on moist dentin etched with PA (control) or on air-dried dentin etched with 3% aluminum nitrate + 2% oxalic acid (AN), 6.8% ferric oxalate + 10% citric acid (FO), or 10% citric acid (CA). The µTBS test used 40 human teeth (n = 10). Failure modes and surface morphology were analyzed by scanning electron microscopy (n = 3), while bonding interface morphology and MMP activity were evaluated by laser scanning confocal microscopy (n = 3). Antibacterial activity was evaluated against S. Mutans biofilm by means of viable cells count (CFU/mL).

RESULTS

PA presented the highest bond strengths regardless of aging time. PA, AN, and CA showed stable bond strengths after one year of storage. Adhesive and mixed failures were predominant in all groups. Thin hybrid layers with short resin tags were observed for the experimental etchants. The AN-based etchant was able to inhibit MMP activity. All tested etchants presented antibacterial activity against S. Mutans biofilm.

SIGNIFICANCE

This study suggests different dentin etchants capable of inhibiting MMP activity while also acting as cavity disinfectants.

Effect of Nonsurgical Periodontal Therapy on Metabolic Control and Systemic Inflammatory Markers in Patients of Type 2 Diabetes Mellitus with Stage III Periodontitis

Background

A reciprocal relationship is understood to exist between periodontal disease and type 2 diabetes mellitus (T2DM), and this intervention study aimed to evaluate the effects of nonsurgical periodontal therapy (NSPT) on metabolic control, systemic inflammation, and cytokines in patients of T2DM with Stage III periodontitis.

Materials and Methods

Sixty patients of T2DM with Stage III periodontitis were divided equally into two groups: intervention group (IG) and control group. Clinical parameters such as bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline and 3 and 6 months, and the serum samples were collected and processed at baseline and 6 months following NSPT to evaluate fasting plasma glucose, Glycosylated hemoglobin (HbA1c), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and high-sensitivity capsule-reactive protein (hs-CRP).

Results

The results indicated a significant improvement in clinical parameters of PPD and CAL 6 months after NSPT (P = 0.005) in both the groups. However, a significant decrease (P < 0.0001) in the TNF-α, hs-CRP, blood glucose, and HbA1c levels was seen after NSPT. On the other hand, an increase in anti-inflammatory cytokine IL-10 was observed after NSPT in the IG. The changes in the pretreatment and posttreatment levels of all clinical, biochemical, and metabolic parameters, were found to be significant in both the groups except BOP.

Conclusion

NSPT effectively improves periodontal condition, systemic inflammatory status, and glycemic control in patients of T2DM with Stage III periodontitis and decreases hs-CRP levels.

Overview on Adjunct Ingredients Used in Hydroxyapatite-Based Oral Care Products

Hydroxyapatite, Ca₅(PO₄)₃(OH), is a biomimetic active ingredient, which is used in commercial oral care products such as toothpastes and mouthwashes worldwide. Clinical studies (in vivo) as well as in situ and in vitro studies have shown the preventive effects of hydroxyapatite in various field of oral care. In some products, hydroxyapatite is combined with other active ingredients, to achieve an additional antibacterial effect or to promote gum health. This review analyzes the efficacy of six selected natural and nature-inspired ingredients that are commonly used together with hydroxyapatite. These additional actives are either antibacterial (lactoferrin, xylitol, and zinc) or promote gum health (allantoin, bisabolol, and hyaluronic acid). A systematic literature search was performed, and all studies found on each ingredient were analyzed. In summary, all analyzed ingredients mentioned in this review are well described in scientific studies on their beneficial effect for oral health and can be used to expand the preventive effect of hydroxyapatite in oral care products.

Investigation of the antimicrobial activities of various antimicrobial agents on Streptococcus Mutans Sortase A through computer-aided drug design (CADD) approaches

BACKGROUND AND OBJECTIVE

Tooth decay is a common chronic disease that causes pain, tooth loss, malnutrition, anxiety and significantly affects half of the world's population. Streptococcus mutans (S.mutans), is considered the main pathogen causing tooth decay. Sortase A (SrtA), one of the surface proteins of S. mutans, is a potential target in the development of antimicrobial and caries prevention agents for preventing infections associated with biofilm formation. Recently, various SrtA inhibitors, including small molecules and natural product, especially, trans-chalcone, chlorhexidine (CHX) and flavonoid compounds, which exhibit effective inhibition against SrtA, have been identified. However, due to the limited number of inhibitors, multi-drug resistance and side-effects the discovery of new inhibitors for SrtA is essential.

METHODS

In this case, various compounds aimed at the target enzyme underwent high-throughput screening with small molecule libraries. For this screening of a total of 178 compounds, 163 were found to be pharmacokinetically suitable by performing an absorption, distribution, metabolism, and excretion (ADME) analysis. Molecular docking was then applied to investigate the interaction mechanism among these suitable compounds and the target enzyme structure at the molecular level.

RESULTS

According to the results of the study, six compounds (CHEMBL243796 (kurarinone), CHEMBL2180472, CHEMBL3335591, CHEMBL373249, CHEMBL1395334, CHEMBL253467 (Isobavachalcone)) exhibited lower docking scores (-7.18, -6.59, -6.53, -6.47, -6.43, and -6.39 kcal/mol, respectively) against S. mutans SrtA than the positive control CHX (-6.29 kcal/mol). Finally, the 100 ns molecular dynamic simulations and binding free energy calculations were performed for the structure stability analysis of the enzyme with CHEMBL243796 (kurarinone), which showed the lowest docking score. As a result of these studies, the stability of the critical interactions between kurarinone and the target enzyme was preserved during the simulation time.

CONCLUSIONS

These results indicate that flavonoid and chalcone scaffold compounds are clinically more reliable and potent than CHX as novel inhibitory agents for inhibiting oral biofilm formation. These finding can provide important contribution to the future clinical trials in the development of therapeutically useful inhibitors of SrtA by virtually screening several chemical compounds more rapidly to select suitable compounds for the prevention and treatment of dental caries.

Enamel remineralization and surface roughness after treatment with herbal-containing toothpastes

Background

Oral care products containing bioactive agents obtained from extracts of plant drugs were launched. This in vitro study investigated the effects of herbal-containing toothpastes associated or not with fluoride to remineralize the enamel after cariogenic challenge with pH cycling. The chemical and physical factors of toothpastes and the enamel surface roughness after brushing were also analyzed.

Material and Methods

Sixty bovine enamel blocks were obtained and divided into 3 thirds: intact (untreated), demineralized (artificial caries lesion), and treated (caries lesion, pH cycling, and brushing with toothpastes). Toothpastes containing herbal compounds contained no fluoride [Galla chinensis (GCH)], low-F concentration [D’Or (DOR); Herbal Bliss (HBL)], or a different fluoride type [Elmex Anticaries (EAC)]. The results were compared to NaF-containing toothpastes: 1450 and 5000 ppm. Enamel blocks were brushed with the toothpastes using a pH-cycling model (7 days). The Knoop hardness (25g/10s) of the surface and the longitudinal sections were then evaluated. The percentage of surface hardness recovery (%SHR) was calculated. The enamel surface roughness, pH, particle size, zeta potential, and polydispersity index of toothpaste slurries were also evaluated. Data were statistically analyzed (α=5%).

Results

No significance was observed when %SHR was compared (p>0.05). DOR, GCH, and HBL were more effective in remineralizing the enamel subsurface. Significantly higher surface roughness was observed when treated with EAC and GCH (p<0.05).

Conclusions

All toothpastes were able to remineralize the enamel, especially the subsurface, with results equal or better than that of standard toothpastes.

Key words:Enamel, hardness, roughness, toothpaste, tooth remineralization.

The effects of cavity disinfection on the nanoleakage of compomer restorations: an in vitro study

Purpose:

Cavity disinfection, in addition to routine caries removal methods, is recommended to eliminate the microorganisms. The aim of this study was to compare the effect of various systems Er,Cr:YSGG lasers, diode lasers and FotoSan and agents Corsodyl; Cervitec and Cervitec Plus and Fluor Protector—on the nanoleakage of compomer restorations when used for cavity disinfection.

Materials and methods:

A total of 40 intact human deciduous molar teeth containing Black V cavities (3×2×1.5 mm) on the buccal and lingual surfaces parallel to the cementoenamel junction were randomly divided into 8 groups according to the cavity disinfection methods. The antibacterial agents and systems were applied according to the manufacturer’s instructions. Restorations were completed using a compomer. The restored teeth were then subjected to thermocycling for 500 cycles in a water bath at 5°C and 55°C with a dwell time of 30 seconds. After the thermocycling procedures, 1-mm sticks were obtained from the center of each cavity to prepare for the nanoleakage test. After the teeth were sectioned, they were immersed in 50 wt % ammoniacal silver nitrate solution for 24 hours and dipped in photo-developing solutions for 8 hours with fluorescent light irradiation. The samples were examined under a scanning electron microscope (SEM). The non-parametric Kruskal-Wallis and Mann-Whitney U test (p<0.05) were applied.

Results:

The Er,Cr:YSGG laser group showed significantly less nanoleakage than all of the tested groups (p<0.01). The diode laser, Fluor protector and FotoSan groups showed similar nanoleakage to that of the control group (p>0.05). The Corsodyl (p<0.01) and Cervitec (p<0.001) groups showed significantly higher nanoleakage than the control group.

Conclusion:

Er,Cr:YSGG laser irradiation which showed lower nanoleakage scores from either control or tested groups can be recommended for cavity disinfection Additionally, a diode laser and FotoSan, which have antibacterial effects and no negative effect on leakage, can be used for cavity disinfection.