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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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Qiu X, Liu J, Chen X. The combination of arginine and fluoride-containing bioactive glass acted synergistically in inhibiting enamel demineralization in permanent teeth. J Dent 2024; 149:105227. [PMID: 38996997 DOI: 10.1016/j.jdent.2024.105227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 06/25/2024] [Accepted: 07/04/2024] [Indexed: 07/14/2024] Open
Abstract
OBJECTIVES To evaluate the in-vitro efficacy of inhibiting enamel demineralization using arginine in combination with fluoride-containing bioactive glass (FBG). METHODS In this study, the healthy enamel blocks were first demineralized in acetic acid for 24 h, then soaked in anti-demineralization treatment solutions containing either arginine or FBG or both for 96 h.The specimens treated in acetic acid were applied as the control group. The pH, calcium and phosphorus ion concentrations of the solutions were measured before and after treatment. Changes in enamel mineral weight, microhardness, and composition were also analyzed. RESULTS The present of arginine facilitated fluorine release from treatment solutions with the presence of FBG. Both arginine and FBG significantly increased the pH of treatment solutions and prevented the further mineral weight loss compared to the control group. All anti-demineralization treatment groups showed significant increases in microhardness, but there was no statistical difference among the treatment groups. The SEM analysis showed enamel restoration in the arginine and FBG groups upon treatment, while the combined groups showing a superior anti-demineralization efficacy. 19F NMR showed the formation of fluorapatite in samples treated with solutions containing FBG. CONCLUSIONS Both arginine and FBG could inhibit enamel demineralization to some extent, and their combination demonstrated an enhanced anti-demineralization efficacy. The low-concentration combination group exhibited anti-demineralization effects comparable to those of high-concentration ones. CLINICAL SIGNIFICANCE This study introduces a new approach for caries prevention by combining the application of arginine and FBG. The release of fluorine promoted by the presented arginine along with calcium and phosphorus ions from FBG facilitated FAP formation. Additionally, the increment of pH resulting from arginine and FBG degradation further prevents enamel demineralization.
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Affiliation(s)
- Xili Qiu
- Hunan Key Laboratory of Oral Health Research & Academician Workstation for Oral-maxillofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, PR China; Molecular Biology Research Center, Center for Medical Genetics, School of Life Sciences, Hunan Province Key Laboratory of Basic and Applied Hematology, Central South University, Changsha, 410013, PR China
| | - Jing Liu
- Molecular Biology Research Center, Center for Medical Genetics, School of Life Sciences, Hunan Province Key Laboratory of Basic and Applied Hematology, Central South University, Changsha, 410013, PR China.
| | - Xiaojing Chen
- Hunan Key Laboratory of Oral Health Research & Academician Workstation for Oral-maxillofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, PR China.
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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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An J, Shen X, Peng T, Qiao M, Xu B. Formulation of arginine-loaded mesoporous silica nanoparticles (Arg@MSNs) modified orthodontic adhesive. J Dent 2024; 145:104992. [PMID: 38599563 DOI: 10.1016/j.jdent.2024.104992] [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: 02/19/2024] [Revised: 04/04/2024] [Accepted: 04/06/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVES The objective of this study was to synthesize arginine loaded mesoporous silica nanoparticles (Arg@MSNs), develop a novel orthodontic adhesive using Arg@MSNs as modifiers, and investigate the adhesive performance, antibacterial activity, and biocompatibility. METHODS Arg@MSNs were synthesized by immobilizing arginine into MSNs and characterized using transmission electron microscope (TEM), dynamic light scattering (DLS), and Fourier Transform Infrared Spectrometer (FT-IR). Arg@MSNs were incorporated into Transbond XT adhesive with different mass fraction to form functional adhesives. The degree of conversion (DC), arginine release behavior, adhesive performance, antibacterial activity against Streptococcus mutans biofilm, and cytotoxicity were comprehensively evaluated. RESULTS TEM, DLS, and FT-IR characterizations confirmed the successful preparation of Arg@MSNs. The incorporation of Arg@MSNs did not significantly affect DC and exhibited clinically acceptable bonding strength. Compared to the commercial control, the Arg@MSNs modified adhesives greatly suppressed the metabolic activity and polysaccharide production while increased the biofilm pH values. The cell counting kit (CCK)-8 test indicated no cytotoxicity. CONCLUSIONS The novel orthodontic adhesive containing Arg@MSNs exhibited significantly enhanced antibacterial activities and inhibitory effects on acid production compared to the commercial adhesive without compromising their bonding strength or biocompatibility. CLINICAL SIGNIFICANCE The novel orthodontic adhesive containing Arg@MSNs exhibits potential clinical benefits in preventing demineralization of enamel surfaces around or beneath orthodontic brackets due to its enhanced antibacterial activities and acid-producing inhibitory effects.
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Affiliation(s)
- Jiali An
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China
| | - Xiao Shen
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China
| | - Tianhao Peng
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China; Peking Union Medical College Hospital, Peking Union Medical College, Beijing 100193, China
| | - Min Qiao
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China.
| | - Baohua Xu
- Department of Orthodontics, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China; Peking Union Medical College Hospital, Peking Union Medical College, Beijing 100193, China.
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Glenny AM, Walsh T, Iwasaki M, Kateeb E, Braga MM, Riley P, Melo P. Development of Tooth Brushing Recommendations Through Professional Consensus. Int Dent J 2024; 74:526-535. [PMID: 38052700 PMCID: PMC11123540 DOI: 10.1016/j.identj.2023.10.018] [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: 07/21/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 12/07/2023] Open
Abstract
INTRODUCTION Despite being a largely preventable disease, untreated caries of permanent teeth is estimated to affect almost 2 billion people worldwide, which is followed by severe periodontal disease. The aim of this work was to provide a professional consensus on tooth brushing methods and associated oral hygiene behaviours and develop evidence-informed recommendations. METHODS An initial scoping search was undertaken to identify systematic reviews of relevance and key questions. This was followed by comprehensive evidence mapping of the literature focussing on systematic reviews and clinical guidelines. Electronic searches of several databases including MEDLINE (via Ovid), Embase (via Ovid), Epistemonikos, and The Cochrane Library were undertaken from 2000 to May 2022, alongside a guideline repository search. Considered Judgement Forms were developed detailing the underpinning evidence, balance between benefits and harms, potential impact on the population, and feasibility of implementation. An online survey comprising 22 draft recommendations was distributed to international members of all FDI committees, including the FDI Council. Participants were asked to indicate to what level they agreed or disagreed with for each recommendation and to provide feedback. The Considered Judgement Forms were provided for reference. RESULTS Three hundred ten records were identified and mapped to different aspects of tooth brushing methods and associated behaviours. Research literature informed 7 Considered Judgement Forms comprising 12 questions with draft recommendations. Twenty-five participants from Asia, Europe, North and South America, Africa, and Australia provided feedback on the recommendations. More than 70% of respondents showed agreement with 21 of the 22 draft recommendations. Final recommendations were drafted with associated strength of recommendation. CONCLUSION Using a robust methodology and an international professional consensus, a set of evidence-informed recommendations was developed. These recommendations provide clinicians with practical guidance to facilitate communications with patients that may help to reinforce individual-level preventive strategies.
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Affiliation(s)
- Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, University of Manchester, UK.
| | - Tanya Walsh
- Division of Dentistry, School of Medical Sciences, University of Manchester, UK.
| | | | - Elham Kateeb
- Oral Health Research and Promotion Unit, Al-Quds University, Jerusalem, State of Palestine
| | | | - Philip Riley
- Division of Dentistry, School of Medical Sciences, University of Manchester, UK
| | - Paulo Melo
- Faculty of Dental Medicine, Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Portugal
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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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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] [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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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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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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Park HY, Kim SW, Seo J, Jung YP, Kim H, Kim AJ, Kim S, Lim K. Dietary Arginine and Citrulline Supplements for Cardiovascular Health and Athletic Performance: A Narrative Review. Nutrients 2023; 15:1268. [PMID: 36904267 PMCID: PMC10005484 DOI: 10.3390/nu15051268] [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: 02/16/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
The global market for nutritional supplements (NS) is growing rapidly, and the use of L-arginine (Arg), L-citrulline (Cit), and citrulline malate (CitMal) supplements has been shown to enhance cardiovascular health and athletic performance. Over the past decade, Arg, Cit, and CitMal supplements have received considerable attention from researchers in the field of exercise nutrition, who have investigated their potential effects on hemodynamic function, endothelial function, aerobic and anaerobic capacity, strength, power, and endurance. Previous studies were reviewed to determine the potential impact of Arg, Cit, and CitMal supplements on cardiovascular health and exercise performance. By synthesizing the existing literature, the study aimed to provide insight into the possible uses and limitations of these supplements for these purposes. The results showed that both recreational and trained athletes did not see improved physical performance or increased nitric oxide (NO) synthesis with 0.075 g or 6 g doses of Arg supplement per body weight. However, 2.4 to 6 g of Cit per day for 7 to 16 days of various NSs had a positive impact, increasing NO synthesis, enhancing athletic performance indicators, and reducing feelings of exertion. The effects of an 8 g acute dose of CitMal supplement were inconsistent, and more research is needed to determine its impact on muscle endurance performance. Based on the positive effects reported in previous studies, further testing is warranted in various populations that may benefit from nutritional supplements, including aerobic and anaerobic athletes, resistance-trained individuals, elderly people, and clinical populations, to determine the impact of different doses, timing of ingestion, and long-term and acute effects of Arg, Cit, and CitMal supplements on cardiovascular health and athletic performance.
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Affiliation(s)
- Hun-Young Park
- Physical Activity and Performance Institute, Konkuk University, Seoul 05029, Republic of Korea
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul 05029, Republic of Korea
| | - Sung-Woo Kim
- Physical Activity and Performance Institute, Konkuk University, Seoul 05029, Republic of Korea
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul 05029, Republic of Korea
| | - Jisoo Seo
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul 05029, Republic of Korea
| | - Yanghoon P. Jung
- CJ CheilJedang Food & Nutrition Tech, Jung-gu, Seoul 04527, Republic of Korea
| | - Hyunji Kim
- CJ CheilJedang Food & Nutrition Tech, Jung-gu, Seoul 04527, Republic of Korea
| | - Ah-Jin Kim
- CJ CheilJedang Food & Nutrition Tech, Jung-gu, Seoul 04527, Republic of Korea
| | - Sonwoo Kim
- CJ CheilJedang Food & Nutrition Tech, Jung-gu, Seoul 04527, Republic of Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute, Konkuk University, Seoul 05029, Republic of Korea
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul 05029, Republic of Korea
- Department of Physical Education, Konkuk University, Seoul 05029, Republic of Korea
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12
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de Sousa Lopes MS, Santana GB, Macena NS, Carvalho GAO, Mota BIS, Prado VLG, Vale GC. Nocturnal Salivary Fluoride Bioavailability After Brushing with a High-fluoride Dentifrice. Biol Trace Elem Res 2022; 200:458-463. [PMID: 33665788 DOI: 10.1007/s12011-021-02658-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/25/2021] [Indexed: 10/22/2022]
Abstract
The use of fluoridated dentifrices is recognized as the main reason for the decline of dental caries and its effect is associated with the bioavailability of fluoride (F) in the oral cavity. High-fluoride dentifrice has been indicated for patients at high risk of caries and management of root lesions. This study aimed to evaluate the bioavailability of F in saliva after the use of high-fluoride dentifrice during the nocturnal period. Fifteen healthy adults participated in this is in vivo and crossover study in which the concentration of F in their saliva was determined after brushing with the tested dentifrices: a conventional (1450 ppm F) or with high-fluoride concentration (5000 ppm F). Before brushing, the participants collected the non-stimulated saliva (baseline), immediately after brushing (time zero) and after 5min, 2h, 4h, and 8h, during the nocturnal period (between 10:00 pm and 06:00 am). The salivary F concentration was determined using a specific F ion electrode. Regarding statistical analysis, a paired t-test was used to compare dentifrices with p fixed at 5%. At baseline, there was no significant difference between groups (p>0.001). Immediately after brushing, both dentifrices increased the F salivary concentration, with the highest concentration reached in time zero; however, the use of 5000 ppm F dentifrice maintained the higher F salivary concentration at all times evaluated (p<0.001), remaining higher until 8 h after brushing. Furthermore, this treatment showed higher F bioavailability in relation to time, evaluated by the area under the curve (p<0.001). Thus, it can be concluded that the high-fluoride dentifrice increased the bioavailability of salivary F during the nocturnal period in comparison with conventional dentifrice.
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Affiliation(s)
- Maria Suzi de Sousa Lopes
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, CEP: 64049-550, Brazil
| | - Guilherme Bandeira Santana
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, CEP: 64049-550, Brazil
| | - Niciane Soares Macena
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, CEP: 64049-550, Brazil
| | - Guereth Alexsanderson Oliveira Carvalho
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, CEP: 64049-550, Brazil
| | - Brenda Izabela Santana Mota
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, CEP: 64049-550, Brazil
| | - Vera Lúcia Gomes Prado
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, CEP: 64049-550, Brazil
| | - Glauber Campos Vale
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, CEP: 64049-550, Brazil.
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Shiraseb F, Asbaghi O, Bagheri R, Wong A, Figueroa A, Mirzaei K. Effect of l-Arginine Supplementation on Blood Pressure in Adults: A Systematic Review and Dose-Response Meta-analysis of Randomized Clinical Trials. Adv Nutr 2021; 13:1226-1242. [PMID: 34967840 PMCID: PMC9340976 DOI: 10.1093/advances/nmab155] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/08/2021] [Accepted: 12/20/2021] [Indexed: 01/01/2023] Open
Abstract
A decade-old meta-analytic work indicated that l-arginine supplementation might have a blood pressure (BP)-lowering effect in different populations. However, several relevant investigations have emerged in the last 10 y, and an up-to-date systematic review and meta-analysis on this topic is currently lacking. Therefore, we aimed to examine the impact of l-arginine supplementation on BP by conducting a systematic review and dose-response meta-analysis of randomized placebo-controlled clinical trials (RCTs). We searched online databases using relevant keywords up to April 2021 to identify RCTs using oral l-arginine on systolic BP (SBP) and diastolic BP (DBP) in adults. Inclusion criteria were adult participants and an intervention duration ≥4 d. Exclusion criteria were the use of l-arginine infusion and acute interventions. A random-effects model was used to estimate the weighted mean difference (WMD) and 95% CI. Twenty-two RCTs with 30 effect sizes were included in this meta-analysis. The pooled analysis demonstrated significant decreases in SBP (WMD = -6.40 mmHg; 95% CI: -8.74, -4.05; P < 0.001) and DBP (WMD = -2.64 mmHg; 95% CI: -3.94, -1.40; P < 0.001) after l-arginine supplementation. Subgroup analysis showed significant reductions in SBP and DBP regardless of baseline BP category (normotensive, hypertensive), study duration (≤24 d, >24 d), sex (female, male), health status (healthy, unhealthy), and BMI (normal, overweight, obese). No significant changes were observed with dosages >9 g/d, trial duration >24 d, or in obese individuals. l-Arginine supplementation also appears to decrease DBP more effectively in females than in males. Moreover, meta-regression analysis for DBP demonstrated a significant relation between the dose of l-arginine intake and changes in DBP (P = 0.020). In the nonlinear dose-response analysis, the effective dosage of l-arginine supplementation was detected to be ≥4 g/d for SBP (P = 0.034), independent of trial duration. Overall, l-arginine supplementation may be effective for decreasing BP. This study was registered at PROSPERO as CRD42021242772.
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Affiliation(s)
- Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
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Sedghi L, DiMassa V, Harrington A, Lynch SV, Kapila YL. The oral microbiome: Role of key organisms and complex networks in oral health and disease. Periodontol 2000 2021; 87:107-131. [PMID: 34463991 PMCID: PMC8457218 DOI: 10.1111/prd.12393] [Citation(s) in RCA: 180] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
States of oral health and disease reflect the compositional and functional capacities of, as well as the interspecies interactions within, the oral microbiota. The oral cavity exists as a highly dynamic microbial environment that harbors many distinct substrata and microenvironments that house diverse microbial communities. Specific to the oral cavity, the nonshedding dental surfaces facilitate the development of highly complex polymicrobial biofilm communities, characterized not only by the distinct microbes comprising them, but cumulatively by their activities. Adding to this complexity, the oral cavity faces near-constant environmental challenges, including those from host diet, salivary flow, masticatory forces, and introduction of exogenous microbes. The composition of the oral microbiome is shaped throughout life by factors including host genetics, maternal transmission, as well as environmental factors, such as dietary habits, oral hygiene practice, medications, and systemic factors. This dynamic ecosystem presents opportunities for oral microbial dysbiosis and the development of dental and periodontal diseases. The application of both in vitro and culture-independent approaches has broadened the mechanistic understandings of complex polymicrobial communities within the oral cavity, as well as the environmental, local, and systemic underpinnings that influence the dynamics of the oral microbiome. Here, we review the present knowledge and current understanding of microbial communities within the oral cavity and the influences and challenges upon this system that encourage homeostasis or provoke microbiome perturbation, and thus contribute to states of oral health or disease.
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Affiliation(s)
- Lea Sedghi
- Department of Orofacial SciencesSchool of DentistryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Vincent DiMassa
- Department of MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Anthony Harrington
- Department of MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Susan V. Lynch
- Department of MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Yvonne L. Kapila
- Department of Orofacial SciencesSchool of DentistryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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Castelo R, Attik N, Catirse ABCEB, Pradelle-Plasse N, Tirapelli C, Grosgogeat B. Is there a preferable management for root caries in middle-aged and older adults? A systematic review. Br Dent J 2021:10.1038/s41415-021-3003-2. [PMID: 34045674 DOI: 10.1038/s41415-021-3003-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/26/2020] [Indexed: 11/09/2022]
Abstract
Aim This systematic review aimed to critically summarise the results of clinical studies investigating agents able to: stop the progression of carious lesions; stop the development of new root carious lesions; preserve the vitality of the infected dental tissues; and increase the surface hardness or change of surface texture, in middle-age and older adults.Methods PubMed, Scopus, and Web of Science were searched systematically, following PRISMA guidelines. Clinical trials published from 2011 to 2020 (March) were included. This systematic review is registered in the PROSPERO database (CRD42018104399). Languages were restricted to English.Results Thirteen of 312 studies were eligible for this review. Eight agents were identified in the studies and their efficacy was assessed using different methods. The agents that presented valuable results on preventing or arresting root caries were 38% silver diamine fluoride (SDF), arginine-containing toothpaste and high-fluoride toothpastes.Conclusions Based on the selected studies' findings, annual applications of 38% SDF could be the most effective treatment for root caries in older adults. In addition, the daily use of a 1.5% arginine toothpaste or a high-fluoride toothpaste could also be recommended. More research on root caries-specific diagnostic methods, especially at very early stages, is necessary.
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Affiliation(s)
- Raísa Castelo
- Departmento de Materiais Dentários e Prótese, Faculdade de Odontologia de Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Université de Lyon - Université Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, F-69622, France
| | - Nina Attik
- Université de Lyon - Université Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, F-69622 Villeurbanne, France; Université de Lyon - Université Claude Bernard Lyon 1, Faculté d'Odontologie, 69008 Lyon, France.
| | | | - Nelly Pradelle-Plasse
- Université de Lyon - Université Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, F-69622 Villeurbanne, France; Département d'Odontologie Conservatrice - Endodontie, Université de Paris, Faculté Dentaire, Hôpital Rothschild, Assistance Publique-Hôpitaux de Paris, France
| | - Camila Tirapelli
- Departmento de Materiais Dentários e Prótese, Faculdade de Odontologia de Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Brigitte Grosgogeat
- Université de Lyon - Université Claude Bernard Lyon 1, UMR CNRS 5615, Laboratoire des Multimatériaux et Interfaces, F-69622 Villeurbanne, France; Université de Lyon - Université Claude Bernard Lyon 1, Faculté d'Odontologie, 69008 Lyon, France; Hospices Civils de Lyon, Centre de Consultations et de Traitements Dentaires, 69007 Lyon, France
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16
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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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Radaic A, Kapila YL. The oralome and its dysbiosis: New insights into oral microbiome-host interactions. Comput Struct Biotechnol J 2021; 19:1335-1360. [PMID: 33777334 PMCID: PMC7960681 DOI: 10.1016/j.csbj.2021.02.010] [Citation(s) in RCA: 153] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023] Open
Abstract
The oralome is the summary of the dynamic interactions orchestrated between the ecological community of oral microorganisms (comprised of up to approximately 1000 species of bacteria, fungi, viruses, archaea and protozoa - the oral microbiome) that live in the oral cavity and the host. These microorganisms form a complex ecosystem that thrive in the dynamic oral environment in a symbiotic relationship with the human host. However, the microbial composition is significantly affected by interspecies and host-microbial interactions, which in turn, can impact the health and disease status of the host. In this review, we discuss the composition of the oralome and inter-species and host-microbial interactions that take place in the oral cavity and examine how these interactions change from healthy (eubiotic) to disease (dysbiotic) states. We further discuss the dysbiotic signatures associated with periodontitis and caries and their sequalae, (e.g., tooth/bone loss and pulpitis), and the systemic diseases associated with these oral diseases, such as infective endocarditis, atherosclerosis, diabetes, Alzheimer's disease and head and neck/oral cancer. We then discuss current computational techniques to assess dysbiotic oral microbiome changes. Lastly, we discuss current and novel techniques for modulation of the dysbiotic oral microbiome that may help in disease prevention and treatment, including standard hygiene methods, prebiotics, probiotics, use of nano-sized drug delivery systems (nano-DDS), extracellular polymeric matrix (EPM) disruption, and host response modulators.
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Affiliation(s)
- Allan Radaic
- Kapila Laboratory, Orofacial Sciences Department, School of Dentistry, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Yvonne L. Kapila
- Kapila Laboratory, Orofacial Sciences Department, School of Dentistry, University of California, San Francisco (UCSF), San Francisco, CA, USA
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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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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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Nyvad B, Takahashi N. Integrated hypothesis of dental caries and periodontal diseases. J Oral Microbiol 2020; 12:1710953. [PMID: 32002131 PMCID: PMC6968559 DOI: 10.1080/20002297.2019.1710953] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/14/2022] Open
Abstract
This review considers an integrated hypothesis of dental caries and periodontal diseases that builds on theoretical ecological principles. The backbone of the hypothesis is based on the dynamic stability stage of the oral microbiota, at which intrinsic (mainly saliva and gingival crevicular fluid) and bacterial (mainly metabolic) resilience factors maintain ecological dynamic stability, compatible with clinical health. However, loss of intrinsic resilience factors and/or prolonged changes in the availability of microbial metabolic substrates may shift the ecological balance of the microbiota into either saccharolytic (acidogenic) or amino acid-degrading/proteolytic (alkalinogenic) stages, depending on the nature of the predominant substrates, leading to clinical diseases. Therefore, to maintain and restore the dynamic stability of the oral microbiota, it is necessary to control the drivers of disease, such as salivary flow and influx of bacterial nutrients into the oral cavity. Contrary to conventional wisdom, excessive intake of fermentable carbohydrates may contribute to inflammation in periodontal tissues resulting from hyperglycaemia. An integrated hypothesis emphasizes that both dental caries and periodontal diseases originate in the dynamic stability stage and emerge in response to nutritional imbalances in the microbiota. Periodontal diseases may belong to the sugar driven inflammatory diseases, similar to diabetes, obesity, and cardiovascular diseases.
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Affiliation(s)
- Bente Nyvad
- Section of Dental Pathology, Operative Dentistry and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Nobuhiro Takahashi
- Division of Oral Ecology and Biochemistry, Department of Oral Biology, Tohoku University Graduate School of Dentistry, Sendai, Japan
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de Amoêdo Campos Velo MM, Agulhari MAS, Rios D, Magalhães AC, Honório HM, Wang L. Root caries lesions inhibition and repair using commercial high-fluoride toothpastes with or without tri-calcium phosphate and conventional toothpastes containing or not 1.5% arginine CaCO3: an in situ investigation. Clin Oral Investig 2019; 24:2295-2304. [DOI: 10.1007/s00784-019-03084-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 09/22/2019] [Indexed: 01/23/2023]
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23
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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: 56] [Impact Index Per Article: 11.2] [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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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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25
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Allen PF, Da Mata C, Hayes M. Minimal intervention dentistry for partially dentate older adults. Gerodontology 2019; 36:92-98. [DOI: 10.1111/ger.12389] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/04/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Martina Hayes
- Cork University Dental School & Hospital, Wilton Cork Ireland
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26
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Baker JL, Edlund A. Exploiting the Oral Microbiome to Prevent Tooth Decay: Has Evolution Already Provided the Best Tools? Front Microbiol 2019; 9:3323. [PMID: 30687294 PMCID: PMC6338091 DOI: 10.3389/fmicb.2018.03323] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 12/20/2018] [Indexed: 12/22/2022] Open
Abstract
To compete in the relatively exposed oral cavity, resident microbes must avoid being replaced by newcomers. This selective constraint, coupled with pressure on the host to cultivate a beneficial microbiome, has rendered a commensal oral microbiota that displays colonization resistance, protecting the human host from invasive species, including pathogens. Rapid increases in carbohydrate consumption have disrupted the evolved homeostasis between the oral microbiota and dental health, reflected by the high prevalence of dental caries. Development of novel modalities to prevent caries has been the subject of a breadth of research. This mini review provides highlights of these endeavors and discusses the rationale and pitfalls behind the major avenues of approach. Despite efficacy, fluoride and other broad-spectrum interventions are unlikely to further reduce the incidence of dental caries. The most promising methodologies in development are those that exploit the exclusive nature of the healthy oral microbiome. Probiotics derived from the dental plaque of healthy individuals sharply antagonize cariogenic species, such as Streptococcus mutans. Meanwhile, targeted antimicrobials allow for the killing of specific pathogens, allowing reestablishment of a healthy microbiome, presumably with its protective effects. The oral microbiota manufactures a massive array of small molecules, some of which are correlated with health and are likely to antagonize pathogens. The prohibitive cost associated with sufficiently rigorous clinical trials, and the status of dental caries as a non-life-threatening condition will likely continue to impede the advancement of new therapeutics to market. Nevertheless, there is room for optimism, as it appears evolution may have already provided the best tools.
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Affiliation(s)
| | - Anna Edlund
- Genomic Medicine Group, J. Craig Venter Institute, La Jolla, CA, United States
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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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Abstract
Dental caries remains a world-wide disease despite the global distribution of fluoride. It has become apparent that the introduction of significant levels of sugar (fermentable carbohydrate) into the diet has resulted in a change in the biofilm, encouraging acid formation. Further, there has been a shift in the microbiota in the biofilm to a flora that produces acid, and thrives and reproduces in an acidic environment. The management of caries activity under these conditions has focused on brushing to remove the biofilm with fluoride pastes, and high-dose fluoride treatments. Kleinberg, in the 1970s, identified an arginine-containing compound in saliva that several oral biofilm bacterial species metabolize to produce base. Multiple in situ and in vivo studies have been conducted, and have discussed the ability of multiple bacteria to increase the resting pH of the biofilm and even reduce the decrease in pH when the biofilm is challenged with glucose. This shift in resting pH can shift the level of caries formation by the biofilm. Here, we present 8 clinical studies, with different clinical designs, measuring different clinical outcomes, for a diverse, world-wide population. Each of these studies demonstrates reductions in caries formation beyond that seen with fluoride alone and several demonstrate the reversal of early caries lesions. Significant clinical research has been shown that 1.5% arginine combined with fluoride toothpaste has superior anti-caries efficacy to toothpaste containing fluoride alone.
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Affiliation(s)
- M S Wolff
- 1 Department of Cariology and Comprehensive Care, NYU College of Dentistry, New York, NY, USA
| | - A B Schenkel
- 1 Department of Cariology and Comprehensive Care, NYU College of Dentistry, New York, NY, USA
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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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30
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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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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: 51] [Impact Index Per Article: 8.5] [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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32
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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: 86] [Impact Index Per Article: 14.3] [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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33
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Comment on the paper entitled 'Arginine and caries prevention: A systematic review'. Br Dent J 2017. [DOI: 10.1038/sj.bdj.2017.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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