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Alblooshi NA, Naseer TK, Bijle MN. Caries preventive potential of professionally deliverable fluoride-containing agents with incorporated arginine: A scoping review. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:154-162. [PMID: 38828462 PMCID: PMC11141041 DOI: 10.1016/j.jdsr.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/08/2023] [Accepted: 05/12/2024] [Indexed: 06/05/2024] Open
Abstract
The scoping review objectives were to: 1) investigate the caries preventive potential of professionally deliverable fluoride (F)-containing agents with incorporated arginine (Arg); and 2) identify the future scope of research on Arg-F interventions for caries prevention. Of 150 identified records, 7 articles (6 in vitro investigations and 1 scoping review) were included for a complete review; with no clinical studies with/without appraisal. Arginine variants (L-Arg/Arg.HCl at 1% to 10% w/v.) were examined for a potential professional application aimed at caries prevention, as reported with in vitro studies. Of the included articles, four in vitro studies explored L-Arg enriched 5% NaF varnish (Duraphat®) as a promising caries preventive agent, while only one considered incorporating L-Arg in MI varnish®/nanohydroxyapatite and one investigated glass ionomer cement for primary/secondary and tertiary caries prevention. The scoping review highlighted the scope for incorporating Arg to professionally deliverable F-containing agents. No clinical data are available to make conclusive recommendations about the caries preventive potential of professionally deliverable F-containing agents with incorporated Arg. With Arg-F varnish being investigated predominantly through in vitro studies, the data so far suggest that Arg was incorporated exclusively in Duraphat®, while the potential of Arg to prevent caries in other F-containing varnishes remains unexplored.
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Affiliation(s)
- Nouf Ali Alblooshi
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Tiba Kahtan Naseer
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Mohammed Nadeem Bijle
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Chen Y, Hao Y, Chen J, Han Q, Wang Z, Peng X, Cheng L. Lacticaseibacillus rhamnosus inhibits the development of dental caries in rat caries model and in vitro. J Dent 2024; 149:105278. [PMID: 39111536 DOI: 10.1016/j.jdent.2024.105278] [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: 03/28/2024] [Revised: 07/27/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024] Open
Abstract
OBJECTIVES Dental caries result from a microbial imbalance in the oral cavity. Probiotics ecologically modulate the oral microflora to prevent caries. This study evaluated the anti-cariogenic effects of two Lacticaseibacillus rhamnosus strains in vitro and in vivo to provide a more theoretical basis for its clinical applications in caries prevention. METHODS In the study, cariogenic biofilms were grown with L. rhamnosus (LGG) or L. rhamnosus ATCC 7469 and analyzed. Quantitative real-time PCR (qPCR), Scanning Electron Microscope (SEM), and Confocal laser scanning microscope (CLSM) were used to detect the changes in the composition and architectures; cariogenic activity was measured by the lactic acid production and Transverse Microradiography (TMR). The effects of LGG on the 12 Sprague-Dawley rat caries model were assessed using Keyes scores and micro-CT analysis. Oral microbiome changes were evaluated through 16S rRNA gene high-throughput sequencing. RESULTS L. rhamnosus can reduce cariogenic bacteria in biofilm by 14.7 % to 48.9 %, with LGG exhibiting more potent inhibitory effects. Both strains of L. rhamnosus can adhere to the surface of biofilms, reduce the extracellular polysaccharides (EPS) matrix, and loosen the biofilm structure. L. rhamnosus inhibited cariogenic activity by reducing the lactic acid production in biofilms. The bovine enamel blocks presented lower mineral loss values and lesion depth values in the group Core+L.rh and Core+LGG. LGG-ingested rats had significantly lower levels of moderate dentin lesions and higher mineral density than the control group. The 16 s rRNA gene sequencing revealed that LGG regulated the beta diversity of the oral microbial community in the rat dental caries model. CONCLUSIONS This study revealed the promising potential of L. rhamnosus, especially the LGG strain, in the ecological prevention of dental caries. CLINICAL SIGNIFICANCE Probiotics may provide a strategy for preventing caries by regulating the oral microecological balance. The study revealed the promising anti-caries potential of the LGG probiotic strain in vivo and in vitro. It is expected that LGG could be used as an oral probiotic for the clinical prevention and treatment of caries.
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Affiliation(s)
- Yanyan Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontic, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China; Department of Stomatology, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, 518107, China
| | - Yu Hao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontic, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jing Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontic, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Qi Han
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontic, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Zheng Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontic, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Xian Peng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontic, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontic, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Bijle MN, Naseer TK, Yiu C. Physical properties and enamel remineralization potential of arginine-fluoride varnishes. J Dent 2024; 148:104965. [PMID: 38548164 DOI: 10.1016/j.jdent.2024.104965] [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: 03/13/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE The study objectives were to examine the physical properties and enamel remineralization potential of fluoride (F) varnishes incorporated with arginine (Arg). METHODS Four commercial F varnishes: 1) Duraphat®; 2) Flúor Protector®, 3) Fluor Protector S®, and 4) Fluorimax™ were supplemented with 2% w/v. Arg. The control/experimental varnishes underwent rheometric analysis to assess varnish density (δ), velocity (ν), and associated viscosity, both quantitatively (ν/δ) and qualitatively based on determined mass, volume, distance flow, and time under experimentation. The varnish wet/dry weights (at 2 h) were also analysed. Further, sound enamel specimens (T0) with artificial incipient caries-like lesions (T1) were treated with control/experimental varnishes and subjected to remineralization assay with artificial saliva for 6 h. Thereafter (T2), the specimens were characterized to estimate precipitated Ca and net enamel F uptake. Additionally, mineral density (MD) was assessed using micro-CT at T0, T1, and T2 to derive mineral gain (MG) and % remineralization for the treatment groups. RESULTS When Arg is incorporated, the physical properties of the F-containing varnishes undergo a significant transformation, resulting in higher density, varnish weight, dry varnish weight, and viscosity compared to their respective control varnishes (p < 0.05). Incorporating Arg-in Duraphat®, Fluor Protector S®, and Fluorimax™ significantly improved both enamel Ca precipitation and F uptake compared to the respective controls (p < 0.05). Additionally, the enamel F uptake was significantly higher with all the tested varnishes when enriched with Arg (p < 0.05). The combined data for MD, MG, and % remineralization suggests that the remineralization potential of F-varnishes significantly increased when enriched with Arg (p < 0.05). CONCLUSION Incorporating Arg in inorganic F varnishes improves their physical properties and enhances the enamel remineralization potential of the varnishes. CLINICAL SIGNIFICANCE This study highlights the possibility of incorporating Arg in distinct F-source varnishes. The synergism between active components (Arg-F) aids in enhanced remineralization and superior varnish physical properties, demonstrating a promising approach for high caries-risk patients.
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Affiliation(s)
- Mohammed Nadeem Bijle
- Post-doctoral Fellow in Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
| | - Tiba Kahtan Naseer
- Intern/Research Assistant, Paediatric Dentistry, Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Cynthia Yiu
- Clinical Professor in Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong
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Miranda ML, Danelon M, Delbem ACB, Kopp W, Nunes GP, Brighenti FL. Enhanced anti-biofilm and anti-caries potential of arginine combined with calcium glycerophosphate and fluoride. J Dent 2024; 146:105039. [PMID: 38714243 DOI: 10.1016/j.jdent.2024.105039] [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: 01/26/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/09/2024] Open
Abstract
OBJECTIVE The aim of this work was to evaluate the antibiofilm and anticaries properties of the association of arginine (Arg) with calcium glycerophosphate (CaGP) and fluoride (F). METHODS An active attachment, polymicrobial biofilm model obtained from saliva and bovine teeth discs were used. After the initial biofilm growth period, the enamel discs were transferred to culture medium. The treatment solutions were added to the culture media to achieve the desired final concentration. The following groups were used: negative control (Control); F (110 ppm F); CaGP (0.05 %); Arg (0.8 %) and their associations (F + CaGP; Arg + F; Arg + CaGP; Arg +F + CaGP). The following analyses were carried out: bacterial viability (total bacteria, aciduric bacteria and mutans streptococci), pH assessment of the spent culture medium, dry weight quantification, evaluation of surface hardness loss (%SH) and subsurface mineral content. Normality and homoscedasticity were tested (Shapiro-Wilk and Levene's test) and the following tests were applied: two-way ANOVA (acidogenicity), Kruskall-Wallis (microbial viability) and one way ANOVA (dry weight, %SH, mineral content). RESULTS The association Arg + F + CaGP resulted in the lowest surface hardness loss in tooth enamel (-10.9 ± 2.3 %; p < 0.05). Arg +F + CaGP exhibited highest values of subsurface mineral content (10.1 ± 2.9 gHAP/cm3) in comparison to Control and F (p < 0.05). In comparison to Control and F, Arg +F + CaGP promoted the highest reduction in aciduric bacteria and mutans streptococci (5.7 ± 0.4; 4.4 ± 0.5 logCFU/mL, p < 0.05). CONCLUSIONS The Arg-F-Ca association demonstrated to be the most effective combination in protecting the loss of surface hardness and subsurface mineral content, in addition to controlling important virulence factors of the cariogenic biofilm. CLINICAL SIGNIFICANCE Our findings provide evidence that the Arg-F-Ca association showed an additive effect, particularly concerning protection against enamel demineralization. The combination of these compounds may be a strategy for patients at high risk of caries.
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Affiliation(s)
- Marina Lins Miranda
- São Paulo State University (UNESP), School of Dentistry, Araraquara, Department of Morphology, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Marcelle Danelon
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Universidade Estadual Paulista (UNESP), Department of Preventive and Restorative Dentistry, Araçatuba, SP, Brasil
| | - Alberto Carlos Botazzo Delbem
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Universidade Estadual Paulista (UNESP), Department of Preventive and Restorative Dentistry, Araçatuba, SP, Brasil
| | - Willian Kopp
- São Paulo State University (UNESP), School of Dentistry, Araraquara, Department of Morphology, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil
| | - Gabriel Pereira Nunes
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Universidade Estadual Paulista (UNESP), Department of Preventive and Restorative Dentistry, Araçatuba, SP, Brasil
| | - Fernanda Lourenção Brighenti
- São Paulo State University (UNESP), School of Dentistry, Araraquara, Department of Morphology, Orthodontics and Pediatric Dentistry, Araraquara, SP, Brazil.
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Joshi S, Vaidya N, Gupta B, Pustake B, Shinde G, Pharande S. A Comparative Evaluation of Arginine Complex Combined With Flouride and Two Standard Non-Fluoridated Remineralizing Agents: An In Vitro Study. Cureus 2024; 16:e60118. [PMID: 38864042 PMCID: PMC11164834 DOI: 10.7759/cureus.60118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2024] [Indexed: 06/13/2024] Open
Abstract
Background Dental caries represents a dynamic process, often reversible in its early stages. Fluoride has conventionally served as the cornerstone for remineralization and early caries arrest. However, excessive fluoride intake can lead to both local and systemic toxicity. Hence, there's a pressing need to develop adjunct therapies that enhance fluoride's efficacy while minimizing its dosage. This study aims to assess and compare the remineralization potential of a novel combination comprising arginine bicarbonate and fluoride against established technologies such as Bioactive glass (NovaMin Technology; Sensodyne Repair and Protect, GlaxoSmithKline, UK) and CPP-ACP technology (GC Tooth Mousse; Tokyo Japan). Materials and methods The experiment utilized extracted premolars designated for orthodontic extraction. The initial evaluation employed the DIAGNOdentTM fluorescence method. Subsequently, teeth underwent demineralization and were measured for values. Following this, the teeth were subjected to seven cycles of remineralization, after which moment values were reassessed. Statistical analysis was performed on the recorded values. Results Participants were divided into six groups (BR-A, AR-A, BR-B, AR-B, BR-C, AR-C). T-tests demonstrated significant reductions in moment values within each group, indicating the effectiveness of all remineralizing agents. Group C exhibited the most substantial difference (-6.900 ± 0.4), followed by Group A and Group B. ANOVA analysis revealed statistically significant differences among all three groups (p=0.016). Tables showed significant distinctions between the remineralizing values of Groups A and C and Groups B and C (p=0.02 and 0.002, respectively), with no discernible distinction between Groups A and B. Conclusion The study elucidates the superior efficacy of the arginine complex with fluoride combination compared to CPP-ACP and Bioactive Glass individually. This finding underscores the potential of the novel combination therapy in enhancing remineralization while minimizing fluoride dosage, thus presenting a promising strategy for addressing early-stage dental caries.
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Affiliation(s)
- Saurabh Joshi
- Department of Pediatric Dentistry, Rural Dental College, Pravara Institute of Medical Sciences, Loni, IND
| | - Nilesh Vaidya
- Department of Conservative Dentistry and Endodontics, Endodontics School of Dental Sciences, Krishna Vishwa Vidyapeeth, Karad, IND
| | - Bharti Gupta
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, SAU
| | - Bhushan Pustake
- Department of Pedodontics and Preventive Dentistry, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray (KBH) Dental College, Nashik, IND
| | - Gaurav Shinde
- Department of Pedodontics and Preventive Dentistry, Rajesh Ramdasji Kambe (RRK) Dental College and Hospital, Akola, IND
| | - Shilpa Pharande
- Department of Orthodontics and Dentofacial Orthopaedics, Sinhgad Dental College and Hospital, Pune, IND
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Alblooshi NA, Krithikadatta J, Yiu C, Bijle MN. Fluoride release potential of arginine-incorporated fluoride varnishes. Dent Mater J 2024; 43:146-154. [PMID: 38233188 DOI: 10.4012/dmj.2023-238] [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] [Indexed: 01/19/2024]
Abstract
The study aimed to examine the fluoride (F) release potential of arginine (Arg)-incorporated F varnishes. Four commercially available F varnishes were included in the study: Duraphat® (5% NaF), Flúor Protector® (0.9% SiH2F2), Fluor Protector S® (NH4F), and Fluorimax™ (2.5% NaF). L-arginine (2% w/v.) was incorporated in these varnishes to estimate F release at 1 h, 4 h, 6 h, 24 h, 3 days, and 7 days using an F-ion selective electrode. The media pH of eluded varnishes was estimated and primary inorganic F extraction was performed. The main effects pH, F release, and computed integrated mean/cumulative F release for experimental groups were significantly higher than the controls (p<0.01). The primary extracted F concentrations for the Arg-containing groups were significantly lower than the control groups (p<0.001) demonstrating a chemical interplay with Arg incorporation. To conclude, irrespective of the inorganic F content, incorporating Arg in F-containing varnishes increases their F release potential.
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Affiliation(s)
- Nouf Ali Alblooshi
- Paediatric Dentistry, Department of Clinical Sciences, College of Dentistry, Ajman University
| | | | - Cynthia Yiu
- Paediatric Dentistry, Faculty of Dentistry, University of Hong Kong
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Yip K, Abdalla MM, Bijle MN, Yiu C. Effect of arginine-fluoride varnish on preventing enamel erosion by paediatric liquid medicaments. BMC Oral Health 2023; 23:892. [PMID: 37985984 PMCID: PMC10662501 DOI: 10.1186/s12903-023-03621-8] [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: 08/11/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The study objective was to examine the effect of arginine-sodium fluoride (Arg-NaF) varnish on preventing enamel erosion by acidic paediatric liquid medicaments (PLM). METHODS The treatment groups were: 1) 2% Arg-NaF; 2) 4% Arg-NaF; 3) 8% Arg-NaF; 4) NaF; 5) MI (CPP-ACFP) varnishes; and 6) no varnish. The pH of PLM (paracetamol and chlorpheniramine) was measured at baseline and after immersing the Perspex® blocks coated with varnishes at 0 min, 30 min, 1 h, and 4 h. Seventy-two enamel specimens (n = 72) were randomly divided into 2 groups by PLM and further by treatment groups. Then, the specimens were pre-treated with varnishes and subjected to erosive cycles (5 min, 2×/day for 4 days) by PLM. After each erosive challenge, the specimens were stored in artificial saliva. At baseline and after 4 days, the specimens were assessed for surface roughness (Ra) using 2D-surface profilometric analysis (SPA) and atomic force microscopy (AFM). Additionally, the Ca/P ratio was determined using scanning electron microscopy with energy-dispersive X-ray spectroscopy. Paired samples dependent t-test, 1-way ANOVA and 2-way ANOVA with Bonferroni post-hoc tests were used to analyse data with the level of significance set at p < 0.05. RESULTS The pH of PLM with 8% Arg-NaF was significantly higher than the other groups at 30 min and 4 h (p < 0.05). With paracetamol, no significant difference was observed between the baseline and post-erosive cycle measured enamel Ra (by SPA/AFM) and Ca/P ratio for all treatment groups (p > 0.05). The Ra determined by AFM, at the post-erosive cycle with chlorpheniramine, when treated with 4 and 8% Arg-NaF was significantly lower than the other groups (p < 0.05); except CPP-ACFP (p > 0.05). With the chlorpheniramine post-erosive cycle, the Ca/P ratio for 4, 8% Arg-NaF and CPP-ACFP treated specimens was significantly higher than the baseline Ca/P (p < 0.05). CONCLUSION The 4%/8% Arg-NaF and MI varnish® application exhibit an enhanced preventive effect against low pH (pH < 3.0) PLM-mediated enamel erosive challenges compared to 5% NaF varnish.
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Affiliation(s)
- Kimberley Yip
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Island, Hong Kong
| | - Mohamed Mahmoud Abdalla
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Island, Hong Kong
- Dental Biomaterials, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohammed Nadeem Bijle
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Island, Hong Kong
| | - Cynthia Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Island, Hong Kong.
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Pørksen CJ, Ekstrand KR, Markvart M, Larsen T, Garrido LE, Bakhshandeh A. The efficacy of combined arginine and probiotics as an add-on to 1450 ppm fluoride toothpaste to prevent and control dental caries in children - A randomized controlled trial. J Dent 2023; 137:104670. [PMID: 37604396 DOI: 10.1016/j.jdent.2023.104670] [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: 07/12/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVES To determine how daily consumption of a lozenge combining arginine and two probiotic strains affects the Relative Risk Reduction (RRR) in children regarding dental caries transitions and lesion activity at tooth surface level during 10-12 months. METHODS A total of 21,888 tooth surfaces in 288 children were examined. The intervention group (n = 141) received a lozenge containing 2% arginine, Lacticaseibacillus rhamnosus, LGG® (DSM33156), and Lactobacillus paracasei subsp. paracasei, L. CASEI 431® (DSM33451). The placebo group (n = 147) received a placebo lozenge. Both groups received 1,450 ppm F- toothpaste. Primary canines, molars, and first permanent molars were examined clinically (ICDAS0-6) and radiographically (R0-6) at baseline and follow-up. Sealed, filled, and missing surfaces were also included. Caries activity was computed as a sum of each caries lesion's location, color, texture, cavitation, and gingival bleeding. RRRs were computed with cluster effect on surface level. ICH-GCP was followed, including external monitoring. RESULTS A total of 19,950 surfaces were analyzed after excluding 1,938 tooth surfaces. No statistically significant differences were found between the groups. The RRRs showed less caries progression (13.6%, p = 0.20), more regression (0.3%, p = 0.44), and fewer active caries lesions (15.3%, p = 0.15) in the intervention group. CONCLUSION Daily consumption of a lozenge combining arginine and probiotics for 10-12 months given to 5-9-years-old children characterized being with low caries risk demonstrated a marked, though not statistically significant RRR for caries progression, regression, and number of active lesions in the intervention group compared to the placebo-group. CLINICALTRIALS gov (NCT03928587). CLINICAL SIGNIFICANCE Since all the RRRs were in favor of the intervention group and the PF of combined arginine and probiotics is high (81.6%) compared to fluoride toothpaste (24.9%) and arginine-fluoride toothpaste alone (19.6%) the combined pre-and probiotics approach may be a future additional tool regarding caries prevention and control.
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Affiliation(s)
- Camilla Juhl Pørksen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Kim Rud Ekstrand
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Merete Markvart
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Tove Larsen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Luis Eduardo Garrido
- School of Psychology, Pontificia Universidad Católica Madre y Maestra, Santo Domingo, Dominican Republic.
| | - Azam Bakhshandeh
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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Goyal V, Damle S, Puranik MP, Nuvvula S, Kakanur M, Marwah N, Asokan S, Suprabha BS, Sreenivasan P, Wadgave U, Shyam S, Thakur D. Arginine: A New Paradigm in Preventive Oral Care. Int J Clin Pediatr Dent 2023; 16:698-706. [PMID: 38162235 PMCID: PMC10753110 DOI: 10.5005/jp-journals-10005-2693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Dental caries is ubiquitous and one of the most prevalent oral diseases and the foremost cause of dental pain and poor quality of life (QoL). Fluoride is an effective caries preventive agent; however, despite its use, there remain some gaps in prevention of dental caries. Arginine, an amino acid, helps to maintain a noncariogenic plaque. It shows synergistic effects with fluoride in dental caries and can help nourish the tooth by enhancing the remineralization effect of fluoride. Supplementing fluoride dentifrices with arginine can bridge the gap in caries prevention. Several clinical studies with 1.5% arginine + fluoride provide evidence for its use in prevention of dental caries. This report throws light on the benefits of arginine in dental caries and guides on its use with fluoride. Recommendations given in the report will help in effective prevention of dental caries. How to cite this article Goyal V, Damle S, Puranik MP, et al. Arginine: A New Paradigm in Preventive Oral Care. Int J Clin Pediatr Dent 2023;16(5):698-706.
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Affiliation(s)
- Varinder Goyal
- Department of Pediatric and Preventive Dentistry, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
| | - Satyawan Damle
- Department of Paediatric Dentistry, M.M. College of Dental Sciences and Research, Maharishi Markandeshwar University, Ambala, Haryana, India
| | - Manjunath P Puranik
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Sivakumar Nuvvula
- Department of Pediatric Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Madhu Kakanur
- Department of Pediatric and Preventive Dentistry, KLE Society's Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - Nikhil Marwah
- Department of Pediatric and Preventive Dentistry, Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan, India
| | - Sharath Asokan
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Baranya S Suprabha
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Manipal, Mangaluru, India
| | - Prathima Sreenivasan
- Department of Oral Medicine and Radiology, Kannur Dental College, Kannur, Kerala, India
| | - Umesh Wadgave
- Department of Public Health Dentistry, Wadgave's Dental Home, Bidar, Karnataka, India
| | - S Shyam
- Department of Public Health Dentistry, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Dewakshi Thakur
- Department of Pediatric and Preventive Dentistry, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
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Pørksen CJ, Keller MK, Damholt A, Frederiksen AKS, Ekstrand KR, Markvart M, Larsen T, Bakhshandeh A. The effect of a lozenge combining prebiotic arginine and probiotics on caries increment in children during 10-12 months, a randomized clinical trial. J Dent 2023; 135:104599. [PMID: 37356561 DOI: 10.1016/j.jdent.2023.104599] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVES To investigate the effect of daily use of a lozenge containing arginine and probiotics for 10-12 months on caries increment, gingivitis- and plaque occurrence in children aged 5-9 years. METHODS In this placebo-controlled, double-blinded, parallel-grouped randomized clinical trial, 343 children were randomly assigned to one of the study arms (1:1). The intervention group (n = 172) received a lozenge containing Lacticaseibacillus rhamnosus, LGG® (DSM33156), Lactobacillus paracasei subsp. paracasei, L. CASEI 431® (DSM33451) and prebiotic (arginine 2%). The placebo group (n = 171) received an identical lozenge without arginine or probiotics. Primary canines and molars, and permanent first molars were examined clinically (d/D= ICDAS1-6) and radiographically (d/D = R1-6) at baseline and follow-up. Missing (m/M), sealed (s/S), and filled (f/F) surfaces (-s/-S) in both dentitions were also included. Utilizing clinical and radiographic scorings, caries experience was classified as dICDAS1-6msf-s (primary teeth), DICDAS1-6MSF-S (permanent teeth), d/DICDAS1-6 m/M-s/S-f/F-s/S (mixed dentition). A weighted and an unweighted score system was applied. RESULTS The study was completed by 288 children. The dropout rate was 15%. The increase in ∆mean dICDAS3-6msf-s and ∆mean d/DICDAS3-6m/M-s/S-f/F-s/S was lower in the intervention group (p = 0.007). No differences were found for gingivitis- and plaque occurrence. No product-related side effects were reported. This study followed ICH-GCP including external monitoring. CONCLUSION Daily consumption of a lozenge containing prebiotic arginine and two strains of probiotics showed safe use and statistically significantly reduction in caries incrementbut no effect on the mean plaque or gingivitis occurrence in children. The use of a lozenge with arginine and probiotics combined has a promising potential as a supplementary tool for future management of caries. www. CLINICALTRIALS gov (NCT03928587). CLINICAL SIGNIFICANCE The combination of prebiotic arginine and probiotics shows clinical potential as a supplementary approach to toothbrushing with fluoride toothpaste in managing caries increment in children. A new era in the management of caries may be emerging.
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Affiliation(s)
- Camilla Juhl Pørksen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, København N 2200 Denmark.
| | - Mette Kirstine Keller
- Clinical Development, Human Health, Health and Nutrition, Chr. Hansen A/S, Kogle Allé 6, Hørsholm 2970, Denmark
| | - Anders Damholt
- Clinical Development, Human Health, Health and Nutrition, Chr. Hansen A/S, Kogle Allé 6, Hørsholm 2970, Denmark
| | | | - Kim Rud Ekstrand
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, København N 2200 Denmark
| | - Merete Markvart
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, København N 2200 Denmark
| | - Tove Larsen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, København N 2200 Denmark
| | - Azam Bakhshandeh
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, København N 2200 Denmark
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11
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He Y, Vasilev K, Zilm P. pH-Responsive Biomaterials for the Treatment of Dental Caries-A Focussed and Critical Review. Pharmaceutics 2023; 15:1837. [PMID: 37514024 PMCID: PMC10385394 DOI: 10.3390/pharmaceutics15071837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Dental caries is a common and costly multifactorial biofilm disease caused by cariogenic bacteria that ferment carbohydrates to lactic acid, demineralizing the inorganic component of teeth. Therefore, low pH (pH 4.5) is a characteristic signal of the localised carious environment, compared to a healthy oral pH range (6.8 to 7.4). The development of pH-responsive delivery systems that release antibacterial agents in response to low pH has gained attention as a targeted therapy for dental caries. Release is triggered by high levels of acidogenic species and their reduction may select for the establishment of health-associated biofilm communities. Moreover, drug efficacy can be amplified by the modification of the delivery system to target adhesion to the plaque biofilm to extend the retention time of antimicrobial agents in the oral cavity. In this review, recent developments of different pH-responsive nanocarriers and their biofilm targeting mechanisms are discussed. This review critically discusses the current state of the art and innovations in the development and use of smart delivery materials for dental caries treatment. The authors' views for the future of the field are also presented.
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Affiliation(s)
- Yanping He
- Adelaide Dental School, University of Adelaide, Adelaide, SA 5000, Australia
| | - Krasimir Vasilev
- College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, SA 5042, Australia
| | - Peter Zilm
- Adelaide Dental School, University of Adelaide, Adelaide, SA 5000, Australia
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12
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Liu S, Song Q, Zhang C, Li M, Li Z, Liu Y, Xu L, Xie X, Zhao L, Zhang R, Wang Q, Zeng G, Zhang Y, Zhang K. Saliva microbiome alterations in dental fluorosis population. J Oral Microbiol 2023; 15:2180927. [PMID: 36844898 PMCID: PMC9946311 DOI: 10.1080/20002297.2023.2180927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Background We aimed to explore saliva microbiome alterations in dental fluorosis population. Methods The prevalence of dental fluorosis was examined in 957 college students. Dean's fluorosis index was used to evaluate the dental fluorosis status. Changes in the composition of the salivary microbiome were assessed in a subset of these patients (100 healthy controls, 100 dental fluorosis patients). Results Dental fluorosis affected 47% of the student sample, and incidence was unrelated to gender. Compared with healthy controls, the microbiota of patients with dental fluorosis exhibited increased diversity, with increased abundance of Treponema lecithinolyticum, Vibrio metschnikovii, Cupriavidus pauculus, Pseudomonas, Pseudomonadaceae, Pseudomonadales, and decreased abundance of Streptococcus mutans, Streptococcus sanguinis, Gemella, and Staphylococcales. Function analyses showed increases in arginine biosynthesis in patients affected by dental fluorosis, together with reductions in amino sugar and nucleotide sugar metabolism, fructose and mannose metabolism, and starch and sucrose metabolism. Conclusions These results suggest that there are striking differences in salivary microbiome between healthy controls and dental fluorosis patients. Dental fluorosis may contribute to periodontitis and systemic lung diseases. There is a need for cohort studies to determine whether altering the salivary microbiota in dental fluorosis patients can alter the development of oral or systemic diseases.
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Affiliation(s)
- Shanshan Liu
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China,Anhui Key Laboratory of Infection and Immunity, Bengbu Medical College, Bengbu, China,Department of Stomatology, Bengbu Medical College, Bengbu, China
| | - Qiangsheng Song
- Department of Stomatology, Huaiyuan county people’s Hospital, Bengbu, China
| | - Chenchen Zhang
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China,Department of Stomatology, Bengbu Medical College, Bengbu, China
| | - Mengwan Li
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Zhenzhen Li
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Yudong Liu
- Department of Histology and Embryology, Bengbu Medical College, Bengbu, China
| | - Li Xu
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xiaofei Xie
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Lili Zhao
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Rongxiu Zhang
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qinglong Wang
- Department of Stomatology, Bengbu Medical College, Bengbu, China
| | - Guojin Zeng
- Department of Stomatology, Bengbu Medical College, Bengbu, China
| | - Yifan Zhang
- Department of Stomatology, Bengbu Medical College, Bengbu, China
| | - Kai Zhang
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China,CONTACT Kai Zhang Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, 287 Chuang Huai Road, Bengbu233004, China
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13
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Razeghian-Jahromi I, Babanouri N, Ebrahimi Z, Najafi HZ, Sarbaz M, Montazeri-Najafabady N. Effect of 8% arginine toothpaste on Streptococcus mutans in patients undergoing fixed orthodontic treatment: randomized controlled trial. Dental Press J Orthod 2022; 27:e2220322. [PMID: 35792788 PMCID: PMC9255989 DOI: 10.1590/2177-6709.27.3.e2220322.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 02/26/2021] [Indexed: 11/22/2022] Open
Abstract
Objective: To assess the effect of toothpaste containing 8% arginine on Streptococcus mutans (S. mutans) in dental plaque around orthodontic brackets, and to draw a comparison with a regular fluoride toothpaste. Trial design: A single-center, parallel-arm, triple-blind, randomized controlled trial was conducted. Methods: The clinical trial was conducted at the Orthodontic Clinic, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Seventy-two patients (age range: 15-30 years) who required fixed orthodontic treatment were recruited and randomly assigned to arginine and fluoride groups. Randomization was performed using RANDOM.ORG online software, and the participants were divided into two parallel groups, with a 1:1 allocation ratio. Patients were requested to brush their teeth twice daily for 30 days with an experimental toothpaste. Plaque sampling was performed at two intervals, namely at the beginning of the study (T0) and 30 days later (T1). Real-time PCR was used to assess plaque samples in terms of the number of S. mutans surrounding stainless steel brackets in orthodontic patients. A triple-blind design was employed. Results: The baseline characteristics (age, sex, and the relative number of S. mutans) between the groups were similar (p>0.05). Only the arginine group showed a significant decrease in the relative number of bacteria between T0 and T1 (p=0.02). Conclusion: Arginine is an important prebiotic agent in maintaining healthy oral biofilms, and prevent dental caries during fixed orthodontic treatments. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (IRCT20181121041713N2), https://en.irct.ir/user/trial/42409/view.
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Affiliation(s)
| | - Neda Babanouri
- Shiraz University of Medical Sciences, Orthodontic Research Center (Shiraz, Iran)
| | - Zahra Ebrahimi
- Shiraz University of Medical Sciences, Orthodontic Research Center (Shiraz, Iran)
| | - Hooman Zarif Najafi
- Shiraz University of Medical Sciences, Orthodontic Research Center (Shiraz, Iran)
| | - Maryam Sarbaz
- Shiraz University of Medical Sciences, Orthodontic Research Center (Shiraz, Iran)
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Shi J, Wang Q, Ruan G, Chen Y, Zhao M, Shi D, Pan B, Xu Z, Zhang T, Wang F, Xu C. Efficacy of probiotics against dental caries in children: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2022; 63:9977-9994. [PMID: 35607893 DOI: 10.1080/10408398.2022.2077693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Dental caries causes serious consequences and the financial burden of society especially in children with high morbidity rate. Here we carried out a meta-analysis to systematically evaluate the efficacy of probiotics against dental caries in children. Forty-three RCTs were eligible for this meta-analysis after searching the PubMed, Cochrane and Web of Science from the inception through October 2021. Pooled estimates demonstrated that treatment with probiotics significantly reduced noncavitated (dicdas2-6mft) (SMD = -0.18, 95% CI: -0.3 to -0.06, p = 0.002) and cavitated (dicdas5-6mft) carious lesions in children (SMD = -0.32, 95% CI: -0.5 to 0.14, p = 0.0004). Probiotics also reduced prevalence of noncavitated (dicdas2-6mft) carious lesions (RR = 0.8, 95% CI: 0.67 to-0.97, p = 0.02). Salivary Streptococcus mutans was declined after intervention (SMD = -1.17, 95% CI: -1.85 to -0.5, p = 0.0007), while Lactobacillus counts were upregulated (SMD = 1.19, 95% CI: 0.46-1.92, p = 0.001). However, no significant effects in total bacteria counts and salivary pH were observed. Our findings suggest that probiotics especially Lactobacillus could be a promising therapeutic strategy for clinical applications in children dental caries.
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Affiliation(s)
- Jiangmin Shi
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qinjian Wang
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Gaoyi Ruan
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yaoxuan Chen
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Min Zhao
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dibang Shi
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Binhui Pan
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhihua Xu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Tiaotiao Zhang
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fangyan Wang
- Department of Pathophysiology, School of Basic Medicine Science, Wenzhou Medical University, Wenzhou, China
| | - Changlong Xu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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15
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Liu Y, Liu S, Zhi Q, Zhuang P, Zhang R, Zhang Z, Zhang K, Sun Y. Arginine-induced metabolomic perturbation in Streptococcus mutans. J Oral Microbiol 2022; 14:2015166. [PMID: 35024088 PMCID: PMC8745357 DOI: 10.1080/20002297.2021.2015166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Streptococcus mutans is a major pathogen responsible for dental caries. Arginine is a promising potential caries preventive agent which can inhibit the growth of S. mutans. However, the mechanism whereby arginine inhibits S. mutans growth remains unclear. Aim To assess the impact of arginine-induced metabolomic perturbations on S. mutans under biofilm conditions. Methods We identified 5,933 and 7,413 ions in positive (ESI+) and negative (ESI-) electrospray ion modes, respectively, with a total of 11.05% and 11.58% differential ions subsequently detected in two respective modes. Further analyses of these metabolites led to identification of 8 and 22 metabolic pathways that were affected by arginine treatment in ESI+ and ESI- modes., Results Once or twice daily treatments of S. mutans biofilms with arginine resulted in reductions in biofilm biomass. Significant reductions in EPS production were observed following twice daily arginine treatments. Identified metabolites that were significantly differentially abundant following arginine treatment were associated with glycolysis metabolism, amino sugar and nucleotide sugar metabolism, and peptidoglycan synthesis. Conclusions Arginine can reduce S. mutans biofilm growth and acid production by inhibiting glycolysis, amino sugar and nucleotide sugar metabolism, and peptidoglycan synthesis.
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Affiliation(s)
- Yudong Liu
- Department of Histology and Embryology, Bengbu Medical College, Bengbu, China.,Anhui Key Laboratory of Infection and Immunity, Bengbu Medical College, Bengbu, China
| | - Shanshan Liu
- Anhui Key Laboratory of Infection and Immunity, Bengbu Medical College, Bengbu, China.,Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qinghui Zhi
- Department of Preventive Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Peilin Zhuang
- Department of Stomatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Rongxiu Zhang
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Zhenzhen Zhang
- Department of Stomatology, Bengbu Medical College, Bengbu, China
| | - Kai Zhang
- Department of Stomatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Yu Sun
- Department of Biochemistry and Molecular Biology, Bengbu Medical College, Bengbu, China
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16
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The Current Strategies in Controlling Oral Diseases by Herbal and Chemical Materials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3423001. [PMID: 34471415 PMCID: PMC8405301 DOI: 10.1155/2021/3423001] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/26/2021] [Indexed: 01/23/2023]
Abstract
Dental plaque is a biofilm composed of complex microbial communities. It is the main cause of major dental diseases such as caries and periodontal diseases. In a healthy state, there is a delicate balance between the dental biofilm and host tissues. Nevertheless, due to the oral cavity changes, this biofilm can become pathogenic. The pathogenic biofilm shifts the balance from demineralization-remineralization to demineralization and results in dental caries. Dentists should consider caries as a result of biological processes of dental plaque and seek treatments for the etiologic factors, not merely look for the treatment of the outcome caused by biofilm, i.e., dental caries. Caries prevention strategies can be classified into three groups based on the role and responsibility of the individuals doing them: (1) community-based strategy, (2) dental professionals-based strategy, and (3) individual-based strategy. The community-based methods include fluoridation of water, salt, and milk. The dental professionals-based methods include professional tooth cleaning and use of varnish, fluoride gel and foam, fissure sealant, and antimicrobial agents. The individual-based (self-care) methods include the use of fluoride toothpaste, fluoride supplements, fluoride mouthwashes, fluoride gels, chlorhexidine gels and mouthwashes, slow-release fluoride devices, oral hygiene, diet control, and noncariogenic sweeteners such as xylitol. This study aimed to study the research in the recent five years (2015–2020) to identify the characteristics of dental biofilm and its role in dental caries and explore the employed approaches to prevent the related infections.
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Bijle MN, Ashraf U, Abdalla MM, Yiu CKY. The effect of arginine-fluoride varnish on biochemical composition of multi-species biofilm. J Dent 2021; 108:103631. [PMID: 33711406 DOI: 10.1016/j.jdent.2021.103631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To examine the biochemical components of multi-species biofilm on the arginine (Arg)-sodium fluoride (NaF) varnish-treated enamel following bacterial pH-cycling. METHODS l-arginine (at 1%, 2%, & 4% w/v.) was incorporated in a 5% NaF varnish. The experimental and control groups were: 1%, 2%, 4% Arg-NaF, NaF, and no treatment. Enamel blocks were prepared, acid-etched, varnish-treated and then subjected to 72 h bacterial pH-cycling in an oral biofilm reactor. The organic (carbohydrates, proteins, amyloids, and eDNA) and inorganic components (calcium, inorganic phosphate, F) were assayed for the obtained biofilm suspensions. The biofilms were stained for exopolysaccharides (EPS)/bacteria and the respective proportions of live/dead bacteria was determined using confocal imaging. RESULTS The total carbohydrate content of the biofilm was the lowest for the 2% and 4% Arg-NaF (p < 0.05). Except for 2% Arg-NaF, the biofilm proteins for 4% Arg-NaF were significantly higher than the other groups (p < 0.05). The amyloids for Arg-NaF groups were significantly lower than the controls (p < 0.05). The eDNA for 4% Arg-NaF was significantly higher than the controls (p < 0.05). The 2% and 4% Arg-NaF-treated enamel had increased biofilm Pi and F compared to the NaF-treated enamel (p < 0.05). The proportion of biofilm EPS matrix to bacteria was significantly reduced in Arg-NaF groups compared to the controls (p < 0.05). The dead bacterial proportions of 4% Arg-NaF were significantly higher than the controls (p < 0.05). CONCLUSION Higher concentrations (i.e. 2%/4%) of Arg in 5% NaF varnish have the potential to modulate the biochemical composition of the biofilm growing on the treated enamel.
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Affiliation(s)
| | - Usman Ashraf
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
| | - Mohamed Mahmoud Abdalla
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong; Dental Biomaterials, Faculty of Dental Medicine Al-Azhar University, Cairo, Egypt.
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Bijle MN, Ekambaram M, Yiu CKY. A Scoping Review on Arginine in Caries Prevention. J Evid Based Dent Pract 2020; 20:101470. [PMID: 32921383 DOI: 10.1016/j.jebdp.2020.101470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/04/2020] [Accepted: 06/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Emerging science on arginine or arginine formulations has driven the need to examine the research in the field. The scoping study objectives were (1) to identify the extent, range, and type of evidence on the role of arginine or arginine formulations in caries prevention and (2) to explore the future scope of research on arginine-containing caries-preventive agents. METHODS A systematic search was performed in PubMed, Scopus, and Web of Science. In vitro studies, clinical trials, narrative reviews, systematic reviews and or meta-analysis, and umbrella reviews or meta-evaluation examining arginine or arginine formulations for caries prevention were included. The data-charting process involved extracting variables followed by evidence synthesis. Arginine variants investigated up to date were discussed to explore future scope of research. RESULTS Thirty-nine articles were included for review from 105 identified citations comprising of in vitro studies, clinical trials, and reviews. Most articles studied 1.5% arginine-fluoride toothpaste. Most studies were from Asia, followed by North America, with fewest studies from Europe and South America. Arginine or arginine formulations demonstrated a superior caries-preventive effect compared with their matched controls (including fluorides); however, the evidence is with high risk of bias. Until now, three arginine variants have been investigated with l-arginine monohydrochloride as the least explored variant. CONCLUSIONS The evidence on the caries-preventive effect of arginine or arginine formulations has a high risk of bias. High-quality clinical trials are needed to assess the caries-preventive potential of arginine in commercial formulations. The role of l-arginine monohydrochloride in caries prevention can further be explored by incorporating in self-applied and professionally applied caries-preventive agents.
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Affiliation(s)
- Mohammed Nadeem Bijle
- PhD Candidate, Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Manikandan Ekambaram
- Senior Lecturer, Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Cynthia Kar Yung Yiu
- Clinical Professor, Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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Bijle MN, Ekambaram M, Lo ECM, Yiu CKY. Synbiotics in caries prevention: A scoping review. PLoS One 2020; 15:e0237547. [PMID: 32785270 PMCID: PMC7423128 DOI: 10.1371/journal.pone.0237547] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023] Open
Abstract
The scoping review aimed to examine the evidence on the role of synbiotics in caries prevention. PubMed, SCOPUS, and Web of Science databases search were performed. Any in vitro study, clinical trial, systematic review with/without meta-analysis, umbrella review/meta-evaluation, narrative review addressing the role of synbiotics in caries prevention were included in the scoping review. Data were extracted from the included studies using pre-approved registered protocol. Twenty-eight records were identified, of which 5 in vitro studies, 1 quasi-experimental clinical trial and 1 narrative review were included in the present review. No controlled clinical trials or systematic reviews on the role of synbiotics in caries prevention could be identified. Except 1, all in vitro studies examined the combined effect of saccharides and lactobacilli spp. as potential synbiotics on the growth of Streptococcus mutans. However, the proposed synbiotics in 4 in vitro studies either did not qualify or remained ambiguous of its eligibility as a potential synbiotic for caries prevention. One recent in vitro study explored the possibility of L-arginine and Lactobacillus rhamnosus GG synbiotic for caries prevention. The quasi-experimental clinical study without a control arm did not explicitly mention the intervention composition and thus, its synbiotic potential remains unclear. A narrative review highlighted the potential of combining arginine (prebiotic) with arginolytic bacteria (probiotic) as a synbiotic, which appears promising for caries prevention. The eligibility of the proposed synbiotics as a true synbiotic needs to be carefully addressed. Due to a lack of controlled clinical studies on synbiotics for caries prevention, evidence on their caries-preventive potential is weak. Future studies are needed to examine the combination of amino acids (esp. arginine) with probiotics as a potential synbiotic against cariogenic pathogens.
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Affiliation(s)
- Mohammed Nadeem Bijle
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Edward C. M. Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
- * E-mail:
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Bijle MN, Ekambaram M, Lo ECM, Yiu CKY. The enamel remineralization potential of fluoride varnishes containing arginine. J Dent 2020; 99:103411. [DOI: 10.1016/j.jdent.2020.103411] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/14/2020] [Accepted: 06/18/2020] [Indexed: 10/24/2022] Open
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Miranda ML, Silva BNS, Salomão KB, de Oliveira AB, Gabbai-Armelin PR, Brighenti FL. Effect of arginine on microorganisms involved in dental caries: a systematic literature review of in vitro studies. BIOFOULING 2020; 36:696-709. [PMID: 32752889 DOI: 10.1080/08927014.2020.1802587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
This systematic review aimed to discuss the effects of arginine on caries-related microorganisms in different in vitro biofilm models. The eligibility criteria were in vitro studies that evaluated the effect of arginine at different concentrations on caries-related microorganisms using biofilm models. Eighteen studies published between 2012 and 2019 were included. Different bacterial species were studied. Seventeen studies (94.4%) achieved a low risk of bias and only one showed a medium risk of bias. The studies showed that arginine is a promising approach for the ecological management of dental caries. The focus of this review was to evaluate the effects of arginine on microorganisms involved in the mechanism of dental caries.
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Affiliation(s)
- Marina Lins Miranda
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Bianca Núbia Souza Silva
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Karina Borges Salomão
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Analú Barros de Oliveira
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Paulo Roberto Gabbai-Armelin
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Fernanda Lourenção Brighenti
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
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22
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Nascimento M, Alvarez A, Huang X, Browngardt C, Jenkins R, Sinhoreti M, Ribeiro A, Dilbone D, Richards V, Garrett T, Burne R. Metabolic Profile of Supragingival Plaque Exposed to Arginine and Fluoride. J Dent Res 2019; 98:1245-1252. [PMID: 31454264 PMCID: PMC6755720 DOI: 10.1177/0022034519869906] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Caries lesions develop when acid production from bacterial metabolism of dietary carbohydrates outweighs the various mechanisms that promote pH homeostasis, including bacterial alkali production. Therapies that provide arginine as a substrate for alkali production in supragingival oral biofilms have strong anticaries potential. The objective of this study was to investigate the metabolic profile of site-specific supragingival plaque in response to the use of arginine (Arg: 1.5% arginine, fluoride-free) or fluoride (F: 1,100 ppm F/NaF) toothpastes. Eighty-three adults of different caries status were recruited and assigned to treatment with Arg or F for 12 wk. Caries lesions were diagnosed using International Caries Detection and Assessment System II, and plaque samples were collected from caries-free and carious tooth surfaces. Taxonomic profiles were obtained by HOMINGS (Human Oral Microbe Identification using Next Generation Sequencing), and plaque metabolism was assessed by the levels of arginine catabolism via the arginine deiminase pathway (ADS), acidogenicity, and global metabolomics. Principal component analysis (PCA), partial least squares-discriminant analysis, analysis of variance, and random forest tests were used to distinguish metabolic profiles. Of the 509 active lesions diagnosed at baseline, 70 (14%) were inactive after 12 wk. Generalized linear model showed that enamel lesions were significantly more likely to become inactive compared to dentin lesions (P < 0.0001), but no difference was found when treatment with Arg was compared to F (P = 0.46). Arg significantly increased plaque ADS activity (P = 0.031) and plaque pH values after incubation with glucose (P = 0.001). F reduced plaque lactate production from endogenous sources (P = 0.02). PCA revealed differences between the metabolic profiles of plaque treated with Arg or F. Arg significantly affected the concentrations of 16 metabolites, including phenethylamine, agmatine, and glucosamine-6-phosphate (P < 0.05), while F affected the concentrations of 9 metabolites, including phenethylamine, N-methyl-glutamate, and agmatine (P < 0.05). The anticaries mechanisms of action of arginine and fluoride are distinct. Arginine metabolism promotes biofilm pH homeostasis, whereas fluoride is thought to enhance resistance of tooth minerals to low pH and reduce acid production by supragingival oral biofilms.
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Affiliation(s)
- M.M. Nascimento
- Department of Restorative Dental
Sciences, Division of Operative Dentistry, College of Dentistry, University of
Florida, Gainesville, FL, USA
| | - A.J. Alvarez
- College of Dentistry, University of
Florida, Gainesville, FL, USA
- Pediatric Dentistry Graduate Program,
Department of Pediatric Dentistry, College of Dentistry, University of Florida,
Gainesville, FL, USA
| | - X. Huang
- Department of Oral Biology, College of
Dentistry, University of Florida, Gainesville, FL, USA
- Division of General Dentistry, Eastman
Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - C. Browngardt
- Department of Oral Biology, College of
Dentistry, University of Florida, Gainesville, FL, USA
| | - R. Jenkins
- Dental Clinical Research Unit, College
of Dentistry, University of Florida, Gainesville, FL, USA
| | - M.C. Sinhoreti
- Dental Materials Division, Department of
Restorative Dentistry, Piracicaba Dental School, State University of Campinas,
Piracicaba, SP, Brazil
| | - A.P.D. Ribeiro
- Department of Restorative Dental
Sciences, Division of Operative Dentistry, College of Dentistry, University of
Florida, Gainesville, FL, USA
| | - D.A. Dilbone
- Department of Restorative Dental
Sciences, Division of Operative Dentistry, College of Dentistry, University of
Florida, Gainesville, FL, USA
| | - V.P. Richards
- Department of Biological Sciences,
College of Science, Clemson University, Clemson, SC, USA
| | - T.J. Garrett
- Department of Pathology, Immunology and
Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL,
USA
| | - R.A. Burne
- Department of Oral Biology, College of
Dentistry, University of Florida, Gainesville, FL, USA
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23
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Bijle MNA, Ekambaram M, Lo ECM, Yiu CKY. The combined antimicrobial effect of arginine and fluoride toothpaste. Sci Rep 2019; 9:8405. [PMID: 31182718 PMCID: PMC6557824 DOI: 10.1038/s41598-019-44612-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 05/08/2019] [Indexed: 02/07/2023] Open
Abstract
The aim of the study was to investigate the antibacterial effect of arginine (Arg) in NaF toothpaste. 24-h mono-/3-species biofilm cultures of S. mutans, S. sanguis and S. gordonii inoculated sHA discs were subjected to treatment with toothpaste supernatants prepared as - [1]:2% Arg -NaF (0.147% F), [2]:4% Arg-NaF (0.144% F), [3]:8% Arg - NaF (0.138% F), [4]:NaF (0.15%) and [5]:deionized water. After 24-h incubation, the mono-species biofilms were subjected to viability assay using WST-8, SEM and confocal imaging (CLSM). The 3-species biofilm were quantified for bacterial composition by PCR analysis, SEM, CLSM, and RNA isolation with reverse-transcription PCR analysis. Increasing arginine concentrations in NaF toothpaste had no effect on microbial viability. The mono-/3-species biofilm imaging depicted that the 2% Arg-NaF and 4% Arg-NaF had a biofilm disrupting effect. The 3-species biofilm bacterial composition indicated that the 2% Arg-NaF group maintained an ecological homeostasis by inhibiting S. mutans growth and enriching the growth of S. sanguis and S. gordonii. The 2% Arg-NaF group significantly downregulated the expression of virulent gtfB gene and upregulated the expression of sagP with relative dominance of arcA. Incorporation of 2% arginine in NaF toothpaste might enrich the alkali-producing bacteria and provide enhanced counter mechanisms against cariogenic pathogen when compared to NaF toothpaste.
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Affiliation(s)
| | | | - Edward C M Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, Hong Kong
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, Hong Kong.
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24
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Twetman S. Prevention of dental caries as a non-communicable disease. Eur J Oral Sci 2019; 126 Suppl 1:19-25. [PMID: 30178558 DOI: 10.1111/eos.12528] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2018] [Indexed: 12/26/2022]
Abstract
Today, dental caries is regarded as a preventable non-communicable disease (NCD) that affects a majority of the population across their lifespan. As such, it shares a number of behavioural, socio-economic, and lifestyle factors with other NCDs, such as overweight and diabetes, and should be subjected to a similar model of chronic disease management. Caries prevention has traditionally relied on fluoride exposure, diet control, thorough oral hygiene, and antibacterial measures. Prevention of caries as an NCD does certainly not disqualify these methods, but brings them into a new context. This conference paper provides a brief review on how common preventive measures can interfere with the drivers of dysbiosis and promote the growth of health-associated clusters in the oral microbiome. Besides the established routines of regular toothbrushing with fluoride products, there is an opportunity for additional technologies, based on ecological principles, to address and modify the oral biofilm. Methods to reduce dietary sugar intake, slow down plaque metabolism, and support saliva functions should be further developed and investigated in terms of efficacy, compliance, and cost-effectiveness. Furthermore, biofilm engineering through pre- and probiotics early in life to support microbial diversity seem promising in order to obtain a sustained caries-preventive effect.
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Affiliation(s)
- Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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25
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Zaura E, Twetman S. Critical Appraisal of Oral Pre- and Probiotics for Caries Prevention and Care. Caries Res 2019; 53:514-526. [PMID: 30947169 DOI: 10.1159/000499037] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 02/20/2019] [Indexed: 11/19/2022] Open
Abstract
In recent years, the concept of preventing caries-related microbial dysbiosis by enhancing the growth and survival of health-associated oral microbiota has emerged. In this article, the current evidence for the role of oral pre- and probiotics in caries prevention and caries management is discussed. Prebiotics are defined as "substrates that are selectively utilized by host microorganisms conferring a health benefit." With regard to caries, this would include alkali-generating substances such as urea and arginine, which are metabolized by some oral bacteria, resulting in ammonia production and increase in pH. While there is no evidence that urea added to chewing gums or mouth rinses significantly contributes to caries inhibition, multiple studies have shown that arginine in consumer products can exert an inhibitory effect on the caries process. Probiotics are "live microorganisms which when administrated in adequate amounts confer a health benefit on the host." Clinical trials have suggested that school-based programs with milk supplemented with probiotics and probiotic lozenges can reduce caries development in preschool children and in schoolchildren with high caries risk. Due to issues with research ethics (prebiotics) and risk of bias (prebiotics, probiotics), the confidence in the effect estimate is however limited. Further long-term clinical studies are needed with orally derived probiotic candidates, including the health-economic perspectives. In particular, the development and evaluation of oral synbiotic products, containing both prebiotics and a probiotic, would be of interest in the future management of dental caries.
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Affiliation(s)
- Egija Zaura
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,
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26
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Bijle MNA, Ekambaram M, Lo EC, Yiu CKY. A META-EPIDEMIOLOGICAL REVIEW OF META-ANALYSIS ON ANTI-CARIES EFFECT OF ARGININE-CONTAINING FORMULATIONS. J Evid Based Dent Pract 2019; 19:28-33. [DOI: 10.1016/j.jebdp.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/20/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
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27
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Oliveira PHC, Oliveira MRC, Oliveira LHC, Sfalcin RA, Pinto MM, Rosa EP, Melo Deana A, Horliana ACRT, César PF, Bussadori SK. Evaluation of Different Dentifrice Compositions for Increasing the Hardness of Demineralized Enamel: An in Vitro Study. Dent J (Basel) 2019; 7:dj7010014. [PMID: 30720710 PMCID: PMC6473709 DOI: 10.3390/dj7010014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/11/2019] [Accepted: 01/18/2019] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate microhardness of a dentifrice containing fluoride and arginine compared to a positive control (fluoride only) and a negative control (no fluoride) on sound and demineralized bovine enamel surfaces. Specimens were randomly assigned to different treatments that included daily pH cycling and brushing three times a day with one of the following dentifrices (n = 8): Neutraçucar (arginine and fluoride), Colgate Total 12 (fluoride) and My First Colgate (no fluoride). Enamel carious lesions were artificially created one week before the beginning of these treatments (demineralized bovine enamel (DE) groups). The same groups were also tested in sound enamel (sound bovine enamel (SE) groups). Microhardness was measured at baseline and after one, two, and five weeks of treatment using a Knoop indenter. Statistical analysis involved two-way Analysis of Variance (ANOVA) and Tukey’s test. After five weeks, both Total 12 and Neutraçucar had increased the microhardness of DE specimens (p < 0.05). Only Neutraçucar had increased the microhardness of the sound enamel after five weeks of treatment. Thus, it could be concluded that arginine-based dentifrices increase the microhardness of sound and demineralized bovine enamel surfaces.
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Affiliation(s)
- Pedro Henrique Cabral Oliveira
- Department of Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Rua Vergueiro 235/249, Liberdade, São Paulo 01504-001, Brazil.
| | - Marcia Regina Cabral Oliveira
- Department of Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Rua Vergueiro 235/249, Liberdade, São Paulo 01504-001, Brazil.
| | - Luiz Henrique Cabral Oliveira
- Department of Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Rua Vergueiro 235/249, Liberdade, São Paulo 01504-001, Brazil.
| | - Ravana Angelini Sfalcin
- Department of Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Rua Vergueiro 235/249, Liberdade, São Paulo 01504-001, Brazil.
| | - Marcelo Mendes Pinto
- Department of Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Rua Vergueiro 235/249, Liberdade, São Paulo 01504-001, Brazil.
| | - Ellen Perin Rosa
- Department of Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Rua Vergueiro 235/249, Liberdade, São Paulo 01504-001, Brazil.
| | - Alessandro Melo Deana
- Department of Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Rua Vergueiro 235/249, Liberdade, São Paulo 01504-001, Brazil.
| | | | - Paulo Francisco César
- Department of Biomaterials and Oral Biology, University of São Paulo, Av. Professor Lineu Prestes, 2227 (Cidade Universitária), São Paulo 05508-900, Brazil.
| | - Sandra Kalil Bussadori
- Department of Biophotonics Applied to Health Sciences, University Nove de Julho (UNINOVE), Rua Vergueiro 235/249, Liberdade, São Paulo 01504-001, Brazil.
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28
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González-Cabezas C, Fernández CE. Recent Advances in Remineralization Therapies for Caries Lesions. Adv Dent Res 2018; 29:55-59. [PMID: 29355426 DOI: 10.1177/0022034517740124] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Remineralization of caries lesions is naturally achieved by salivary ions, and it can be enhanced by external factors or elements such as fluoride. Numerous studies have demonstrated the remineralizing efficacy of fluoride therapies as well as the limitations with some groups of the population. Consequently, developing new remineralization therapies to close this gap in efficacy has been a priority for the last 2 decades. In this review, we summarize and briefly discuss some of the latest advances in remineralization therapies. Most new therapies try to enhance the effect of fluoride by adding other potentially active ingredients to the formulation, such as calcium, phosphate, stannous, xylitol, and arginine. Other remineralization strategies have focused on creating remineralizing scaffolds within the lesions (e.g., self-assembling peptides). While several of the new remineralization strategies have progressed significantly in recent years, for most of them, the evidence is still insufficient to assess their true clinical potential.
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Affiliation(s)
- C González-Cabezas
- 1 Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - C E Fernández
- 1 Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,2 College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL, USA
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29
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Bijle MNA, Ekambaram M, Lo ECM, Yiu CKY. The combined enamel remineralization potential of arginine and fluoride toothpaste. J Dent 2018; 76:75-82. [DOI: 10.1016/j.jdent.2018.06.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/17/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022] Open
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30
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Bijle MNA, Yiu CKY, Ekambaram M. Calcium-Based Caries Preventive Agents: A Meta-evaluation of Systematic Reviews and Meta-analysis. J Evid Based Dent Pract 2018; 18:203-217.e4. [DOI: 10.1016/j.jebdp.2017.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 09/18/2017] [Accepted: 09/18/2017] [Indexed: 12/13/2022]
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31
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Sanchez AY, de Oliveira CL, Negrini TC, Hashizume LN, Hara AT, Maltz M, Arthur RA. In situ Effect of Arginine-Containing Dentifrice on Plaque Composition and on Enamel Demineralization under Distinct Cariogenic Conditions. Caries Res 2018; 52:588-597. [PMID: 29730666 DOI: 10.1159/000488212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 03/06/2018] [Indexed: 11/19/2022] Open
Abstract
There is limited evidence that arginine-containing fluoridated dentifrices (AFD) have a better anticaries effect than regular fluoridated dentifrices (FD), especially in subjects at a higher risk for caries development. This study aimed to assess the effect of AFD on enamel demineralization and on the microbial and biochemical compositions of biofilm formed under different frequencies of sucrose exposure. It consisted of an in situ split-mouth design, where 12 adult volunteers who used FD for at least 2 months prior to the beginning of this study wore acrylic palatal appliances containing 4 bovine enamel specimens (1 pair at each side of the appliance) during 2 phases of 14 days each. FD slurry (3×/day) and 20% sucrose solution (4× and 8×/day) were dripped on the specimens during the first experimental phase. The same volunteers then used AFD during a 2-month washout period, followed by a second experimental phase where the AFD slurry and sucrose solution were applied onto a new subset of specimens. The percentage of enamel surface hardness loss (%SHL), the lesion depth (LD), the integrated mineral loss (IML), microbial counts on biofilms, the biomass, and inorganic and insoluble extracellular polysaccharide (IEPS) biofilm concentrations were determined. Higher %SHL, biomass, and IEPS and lower fluoride values were found at sucrose 8×/day exposure. Lower IEPS were found in the presence of AFD compared to FD. Similar %SHL, LD, and IML values were found between FD and AFD, irrespectively of the cariogenic challenge. The results suggest that AFD have an anticaries effect similar to that of regular FD.
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Affiliation(s)
- Angel Y Sanchez
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Caroline L de Oliveira
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Thais C Negrini
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Lina N Hashizume
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Anderson T Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry (IUSD), Indianapolis, Indiana, USA
| | - Marisa Maltz
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Rodrigo A Arthur
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre,
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32
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Beyond Streptococcus mutans: clinical implications of the evolving dental caries aetiological paradigms and its associated microbiome. Br Dent J 2018; 224:219-225. [PMID: 29449651 DOI: 10.1038/sj.bdj.2018.81] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 11/09/2022]
Abstract
Aetiological concepts of dental caries have evolved over the years from being considered as a disease initiated by nonspecific microorganisms, to being regarded as an 'infectious' disease caused by specific bacteria, to the current paradigms that emphasise a 'mixed bacterial-ecological approach' as being responsible for lesion initiation and pathogenesis. These aetiological paradigms are not just intellectual concepts but have important implications on how clinicians manage this age-old disease in the twenty-first century. Despite evidence-backed recommendations for adopting more biological measures to counter the disease, a significant proportion of dentists continue following traditional caries management guidelines in their daily clinical practice. This paper will review the evolving dental caries aetiological concepts and highlight the current evidence for adopting a more ecological approach to caries prevention, risk assessment, and treatment.
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33
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Philip N, Suneja B, Walsh LJ. Ecological Approaches to Dental Caries Prevention: Paradigm Shift or Shibboleth? Caries Res 2018; 52:153-165. [PMID: 29320767 DOI: 10.1159/000484985] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Contemporary paradigms of dental caries aetiology focus on the ecology of the dental plaque biofilm and how local environmental factors can modulate this to cause disease. The crucial role that a healthy oral microbiome plays in preventing caries and promoting oral health is also being increasingly recognized. Based on these concepts, several ecological preventive approaches have been developed that could potentially broaden the arsenal of currently available caries-preventive measures. Many of these ecological approaches aim for long-term caries control by either disrupting cariogenic virulence factors without affecting bacterial viability, or include measures that can enhance the growth of health-associated, microbially diverse communities in the oral microbiome. This paper argues for the need to develop ecological preventive measures that go beyond conventional caries-preventive methods, and discusses whether these ecological approaches can be effective in reducing the severity of caries by promoting stable, health-associated oral biofilm communities.
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Affiliation(s)
- Nebu Philip
- School of Dentistry, The University of Queensland, Brisbane, QLD, Australia
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Abstract
Data sourcesPubMed, the Cochrane Library, Centre for Reviews and Dissemination (CRD) and Embase.Data abstraction and synthesisTwo independent reviewers selected studies, abstracted data and assessed study quality using the GRADE criteria. Meta-analysis was conducted using a random effects model.Study selectionRandomised controlled trials including in situ studies.ResultsSeven studies were included, five conducted in children and two in adults. The two adult studies and one child study were considered to be at high risk of bias. The remaining four child studies were considered to be at moderate risk of bias. These four studies compared 1450ppm fluoride toothpaste with 1.5% arginine against 1450ppm fluoride toothpaste as a control. Meta-analysis of three studies showed a positive effect on caries measured using quantitative light-induced fluorescence (QLF) in favour of arginine; mean difference -4.67, (95%CI, -6.34 to -3.01). The overall GRADE assessment of this was considered to be very low.ConclusionAt present there is insufficient evidence in support of a caries-preventive effect for the inclusion of arginine in toothpastes. More rigorous studies, and studies which are less dependent on commercial interests, are required.
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35
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Yu Y, Wang X, Ge C, Wang B, Cheng C, Gan YH. Effects of rinsing with arginine bicarbonate and urea solutions on initial enamel lesionsin situ. Oral Dis 2017; 23:353-359. [PMID: 27917567 DOI: 10.1111/odi.12618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/25/2016] [Accepted: 11/24/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Y Yu
- Central Laboratory; Peking University School and Hospital of Stomatology; Beijing Haidian District China
| | - X Wang
- Central Laboratory; Peking University School and Hospital of Stomatology; Beijing Haidian District China
| | - C Ge
- Department of Prosthodontics; Peking University School and Hospital of Stomatology; Beijing Haidian District China
| | - B Wang
- Department of Prosthodontics; Peking University School and Hospital of Stomatology; Beijing Haidian District China
| | - C Cheng
- Central Laboratory; Peking University School and Hospital of Stomatology; Beijing Haidian District China
| | - Y-H Gan
- Central Laboratory; Peking University School and Hospital of Stomatology; Beijing Haidian District China
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