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Liang NL, Luo BW, Sun IG, Chu CH, Duangthip D. Clinical Effects of Sugar Substitutes on Cariogenic Bacteria: A Systematic Review and Meta-Analysis. Int Dent J 2024:S0020-6539(24)00062-5. [PMID: 38599933 DOI: 10.1016/j.identj.2024.02.008] [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: 11/22/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The use of sugar substitutes in food products has recently increased. Limited information regarding the role of various sugar substitutes in caries prevention was found. This systematic review and meta-analysis was conducted to investigate the effects of sugar substitute consumption on reducing cariogenic bacteria in dental plaque and saliva. METHODS We systematically searched PubMed, EMBASE, and Web of Science (inception to July 2023) for prospective controlled trials published in English and investigated the effects of sugar substitute consumption on cariogenic bacteria in dental plaque and saliva. The primary outcome was the changes in cariogenic bacteria. Two independent reviewers screened the papers. Quality was assessed using the Cochrane risk-of-bias tools. RESULTS From 977 studies identified, 32 trials were included. Almost half (14/32, 44%) of the included studies had a high risk of bias. Almost all (31/32, 96.88%) were investigations of xylitol and other sugar alcohols (low-intensity sweeteners), such as sorbitol, erythritol, and maltitol. Only one trial investigated stevia, a high-intensity sweetener, whereas no studies on other high-intensity sweeteners, such as sucralose, saccharin, or aspartame, were found. Almost all studies (30/32, 93.75%) showed the consumption of low-intensity sweeteners led to a significant reduction of different types of cariogenic bacteria. The results of the meta-analysis showed that consumption of low-intensity sweeteners led to a significant reduction of cariogenic bacteria in both dental plaque and saliva compared to no treatment. CONCLUSION The consumption of low-intensity sweeteners helps reduce cariogenic bacteria in dental plaque and saliva. There is limited clinical evidence regarding the role of high-intensity sweeteners in reducing cariogenic bacteria.
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Affiliation(s)
| | - Bella Weijia Luo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; College of Dentistry, The Ohio State University, Columbus, Ohio, USA.
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Kaveh M, Yeganehzad S, Rabie Ashkezary M, Hesarinejad MA, Todaro A, Nishinari K. Chewing gum base: A comprehensive review of composition, production, and assessment methods: Advances and approaches in biodegradability. J Texture Stud 2023; 54:789-807. [PMID: 37584385 DOI: 10.1111/jtxs.12793] [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: 05/21/2023] [Revised: 07/05/2023] [Accepted: 07/25/2023] [Indexed: 08/17/2023]
Abstract
The gum base mass is a colloidal system and the main component of chewing gum; which is an inert, non-nutritious, indigestible, and insoluble part of chewing gum, therefore this substance does not dissolve in the mouth when chewed. The gum base plays the most crucial role in determining the mechanical properties, flexibility, and overall quality of chewing gum. Moreover, it acts as a delivery system to transport sweeteners, flavorings, and other ingredients in chewing gum. Despite the massive market for chewing gum and the provision of a list of the main ingredients in gum base by the Code of Federal Regulations and some international organizations, there is a lack of information about chewing gum base and its compositions in the literature. Therefore, the purpose of this review is to present an overview of the characteristics, ingredients and applications, production process, assessment, and modification methods of the gum base along with the advances and approaches in biodegradability. Biodegradability concerns play a promoting role in the research and development of chewing gum and its applications in the food industry, medical and dental sectors. Reviewing previous studies can surely help for faster development of this path.
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Affiliation(s)
- Mona Kaveh
- Department of Food Processing, Research Institute of Food Science and Technology (RIFST), Mashhad, Iran
| | - Samira Yeganehzad
- Department of Food Processing, Research Institute of Food Science and Technology (RIFST), Mashhad, Iran
| | - Mansour Rabie Ashkezary
- Department of Agriculture, Food and Forest Sciences, Università degli Studi di Palermo, Palermo, Italy
| | - Mohammad Ali Hesarinejad
- Department of Food Processing, Research Institute of Food Science and Technology (RIFST), Mashhad, Iran
| | - Aldo Todaro
- Department of Agriculture, Food and Forest Sciences, Università degli Studi di Palermo, Palermo, Italy
| | - Katsuyoshi Nishinari
- Glyn O. Phillips Hydrocolloid Research Centre, School of Food and Biological Engineering, Hubei University of Technology, Wuhan, China
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Tafti SD, Parisay I, Mehrabkhani M, Sabbagh S, Seddigh S, Ghazvini K, Daghestani N. Effects of probiotic yogurt, casein phosphopeptide-amorphous calcium phosphate, and xylitol chewing gums on the salivary count of Streptococcus mutans: A single-blinded randomized controlled clinical trial. Dent Res J (Isfahan) 2023; 20:115. [PMID: 38169764 PMCID: PMC10758387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/30/2023] [Accepted: 10/23/2023] [Indexed: 01/05/2024] Open
Abstract
Background Dental caries is a preventable multifactorial disease, with Streptococcus mutans being suggested to be its primary pathogen. Our study aim was to compare the effects of three different low-cost and easy-to-use regimens with that of the gold standard (chlorhexidine [CHX] mouthwash) on the count of salivary S. mutans in dental students over 30 days. Materials and Methods In this single-blinded parallel randomized controlled clinical trial, a total of 120 dental students were included and randomly allocated into four intervention groups: (1) CHX mouthwash (control(, (2) probiotic yogurt, (3) casein phosphopeptide-amorphous calcium phosphate chewing gum, and (4) xylitol chewing gum. Salivary S. mutans counts were evaluated at baseline, 15 days, and 30 days after initiation of the study and compared at different times and among different groups using the repeated measures analysis of variance design analysis and least significant difference test with SPSS software version 20. The level of significance was determined to be 0.05. Results The microorganism count variable at baseline, first, and second follow-ups was significantly different for all groups except the probiotic yogurt group (P = 0.340). S. mutans count was significantly different when comparing the first follow-up and baseline values in the CHX and xylitol gum groups (P = 0.027, P = 0.037). When comparing the second follow-up with baseline values, a significant difference was observed in the xylitol gum group (P = 0.003). Conclusion Xylitol chewing gum seems to be a viable alternative to the gold standard (CHX mouthwash) in reducing the salivary count of S. mutans.
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Affiliation(s)
- Samira Dehghani Tafti
- Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Pittsburgh, PA, USA
| | - Iman Parisay
- Dental Materials Research Center, School of Dentistry, Mashhad University of Medical Sciences, Pittsburgh, PA, USA
| | - Maryam Mehrabkhani
- Dental Materials Research Center, School of Dentistry, Mashhad University of Medical Sciences, Pittsburgh, PA, USA
| | - Sedigheh Sabbagh
- Dental Materials Research Center, School of Dentistry, Mashhad University of Medical Sciences, Pittsburgh, PA, USA
| | - Sadaf Seddigh
- School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kiarash Ghazvini
- Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naeemeh Daghestani
- Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Pittsburgh, PA, USA
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Almarsomy DH, Al-khayat FA, Al-Taee LA. The preventive/therapeutic effect of CO 2 laser and MI Paste Plus® on intact and demineralized enamel against Streptococcus mutans (In Vitro Study). Heliyon 2023; 9:e20310. [PMID: 37790956 PMCID: PMC10543189 DOI: 10.1016/j.heliyon.2023.e20310] [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] [Received: 03/09/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023] Open
Abstract
Background To evaluate the preventive and therapeutic effects of CO2 laser and MI paste plus on intact and demineralized enamel surfaces and their impact on bacterial adhesion. Methods: 160 enamel slabs were prepared and randomly allocated into two main groups; sound and demineralized enamel (n = 80 per group), in which specimens were immersed in a demineralizing solution (50 mM acetic acid, pH 4.5) for 72 h at 37 °C. Each group was further divided into four subgroups (n = 20); the control (un treated surfaces), surfaces treated by CO2 laser, MI paste plus (Recaldent™, GC corporation/Germany), and those received a combination of CO2 and MI paste plus. Streptococcus Mutans biofilm was isolated, quantified, and then applied on treated enamel surfaces and incubated anaerobically for 24 h and then quantified by colony-forming unit (CFU). Meanwhile, surface changes were assessed by Vickers microhardness and Scanning Electron Microscope combined with Energy-Dispersive X-Ray Spectroscopy (SEM-EDX). Results: The combined use of CO2 laser followed by MI paste plus significantly (p < 0.000) enhanced surface microhardness of sound and demineralized enamel with a significant reduction in bacterial counts. However, each technique alone was beneficial as they exhibited higher microhardness with lower bacterial viability in comparison to the control. The treatment of demineralized enamel surfaces with MI paste significantly reduced the number of bacterial colonies with the presence of dispersed mineral deposits over the surface. Conclusions The combined use of CO2 laser and MI paste plus was effective as a preventive and/or therapeutic measures in enhancing surface properties of enamel and reducing the bacterial viability.
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Affiliation(s)
- Dhuha H. Almarsomy
- Department of Conservative and Aesthetic Dentistry, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Fadia A. Al-khayat
- Department of Basic Sciences, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Lamis A. Al-Taee
- Department of Conservative and Aesthetic Dentistry, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq
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Alkarad L, Alkhouli M, Dashash M. Remineralization of teeth with casein phosphopeptide-amorphous calcium phosphate: analysis of salivary pH and the rate of salivary flow. BDJ Open 2023; 9:16. [PMID: 37041136 PMCID: PMC10090128 DOI: 10.1038/s41405-023-00141-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/07/2023] [Accepted: 03/23/2023] [Indexed: 04/13/2023] Open
Abstract
AIM To investigate the changes of salivary flow rate and salivary pH of Syrian children with mixed dentition following application of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP). METHODS This study is part of a double-blind randomized controlled clinical trial. It included 50 children aged 6-8 who were randomly divided into two treatment groups to receive either CPP-ACP GC Tooth Mousse™ (Group A) or placebo (Group B) with 25 participants per group. After the application of the product in the mouth for 3 min, saliva samples were collected four times (T0, T1, T2, and T3) to measure salivary pH and the rate of salivary flow. RESULTS There was no significant difference between group A and B in the mean value of salivary flow rate (t = 1.08, P = 0.28, 0.57 ± 0.28 versus 0.56 ± 0.38 respectively) and salivary pH (t = 0.61, P = 0.54, 7.28 ± 0.44 versus 7.25 ± 0.36 respectively). However, there was a significant difference between different time points (T0, T1, T2, and T3) in the mean value of salivary flow rate (0.41 ± 0.30, 0.65 ± 0.36, 0.53 ± 0.28, and 0.56 ± 0.34 respectively) and salivary pH (6.99 ± 0.44, 7.46 ± 0.36, 7.36 ± 0.32, and 7.26 ± 0.32 respectively). CONCLUSION The application of the GC Tooth Mouse (CPP-ACP) was similar to placebo in increasing the salivary pH and salivary flow rate. TRIAL REGISTRATION ISRCTN17509082, Registration date 22/11/2022.
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Affiliation(s)
- Lubna Alkarad
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Muaaz Alkhouli
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Mayssoon Dashash
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
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Dorozhkin SV. Synthetic amorphous calcium phosphates (ACPs): preparation, structure, properties, and biomedical applications. Biomater Sci 2021; 9:7748-7798. [PMID: 34755730 DOI: 10.1039/d1bm01239h] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Amorphous calcium phosphates (ACPs) represent a metastable amorphous state of other calcium orthophosphates (abbreviated as CaPO4) possessing variable compositional but rather identical glass-like physical properties, in which there are neither translational nor orientational long-range orders of the atomic positions. In nature, ACPs of a biological origin are found in the calcified tissues of mammals, some parts of primitive organisms, as well as in the mammalian milk. Manmade ACPs can be synthesized in a laboratory by various methods including wet-chemical precipitation, in which they are the first solid phases, precipitated after a rapid mixing of aqueous solutions containing dissolved ions of Ca2+ and PO43- in sufficient amounts. Due to the amorphous nature, all types of synthetic ACPs appear to be thermodynamically unstable and, unless stored in dry conditions or doped by stabilizers, they tend to transform spontaneously to crystalline CaPO4, mainly to ones with an apatitic structure. This intrinsic metastability of the ACPs is of a great biological relevance. In particular, the initiating role that metastable ACPs play in matrix vesicle biomineralization raises their importance from a mere laboratory curiosity to that of a reasonable key intermediate in skeletal calcifications. In addition, synthetic ACPs appear to be very promising biomaterials both for manufacturing artificial bone grafts and for dental applications. In this review, the current knowledge on the occurrence, structural design, chemical composition, preparation, properties, and biomedical applications of the synthetic ACPs have been summarized.
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Khoramian Tusi S, Jafari A, Marashi SMA, Faramarzi Niknam S, Farid M, Ansari M. The effect of antimicrobial activity of Teucrium Polium on Oral Streptococcus Mutans: a randomized cross-over clinical trial study. BMC Oral Health 2020; 20:130. [PMID: 32357889 PMCID: PMC7195746 DOI: 10.1186/s12903-020-01116-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/19/2020] [Indexed: 01/05/2023] Open
Abstract
Background The purpose of this study is to determine the effect of a mouthwash containing Teucriumpolium herb on Streptococcus mutans in mouth. Methods This study was a randomized, crossover, double-blind clinical trial, where we selected 22 volunteers (dental students) randomly and we divided them into two groups. The study had two phases. In each phase, one group acted as the intervention group, while the other one was the control group. Both the intervention and control groups were given the mouthwash with and without Teucriumpolium, respectively. S. mutans of saliva were measured before and after each phase to compare the effects of the mouthwashes. A three-week washout period was considered between the two phases. An independent two-sample t-test was utilized to compare the mean of S. mutans colonies. Additionally, we used a standard AB/BA crossover model to find the results of the treatment and the impact of carryover on the residual’s biological effects. The significance level was considered 0.05 in this experiment. Results There is no significant difference observed between the two groups in the number of S. mutans before using the mouthwashes. When the mouthwash containing Teucriumpolium was used, there was a significant decrease in the number of S. mutans colonies in both phases’ extract (P = 0.002). Conclusion: The results of this study indicate the mouthwash containing aqueous extract of Teucrium polium can majorly reduce the colonization of S. mutans in human saliva. Trial registration Ethical issues approved by the Ethics Committee of the Rafsanjan University of Medical Sciences with the approval number of 937/9/31, IRCT code Number of IRCT2013121815842N1 and it was approved on 06/16/2014. The study was conducted in the period of September to November 2014.
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Affiliation(s)
- Somayeh Khoramian Tusi
- Department of Pediatric Dentistry, School of Dentistry, Alborz University of Medical Sciences, Alborz, Iran
| | - Ahmad Jafari
- Research Center for Caries Prevention, Dental Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Pediatric Dentistry, School of Dentistry, Al Hussain University, Karbala, Iraq.
| | | | - Salomeh Faramarzi Niknam
- Department of Pediatric Dentistry, School of Dentistry, Alborz University of Medical Sciences, Alborz, Iran
| | - Malihe Farid
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Alborz, Iran
| | - Mehdi Ansari
- Department of Pharmaceutics, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
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8
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Sahin F, Oznurhan F. Antibacterial efficacy and remineralization capacity of glycyrrhizic acid added casein phosphopeptide-amorphous calcium phosphate. Microsc Res Tech 2020; 83:744-754. [PMID: 32191375 DOI: 10.1002/jemt.23465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 12/16/2022]
Abstract
The aim was to evaluate remineralization capacity and antibacterial efficiency of Tooth Mousse and various amounts of glycyrrhizic acid added Tooth Mousse on primary tooth enamel. Three groups were formed; Group 1 (CPP-ACP), Group 2 (CPP-ACP + 5% glycyrrhizic acid), and Group 3 (CPP-ACP + 10% glycyrrhizic acid) in order to evaluate remineralization capacity. Enamel samples were immersed in demineralization solution and then remineralization agents were applied. Surface microhardness and SEM analyses were performed at the beginning, after demineralization and remineralization. For antibacterial tests, four groups were formed; Group 1, Group 2 and Group 3 and Group 4 (control). Biofilms were then exposed to 10% sucrose eight times per day for 7 days. After biofilm growth period, samples were treated with materials to evaluate antibacterial efficiency except control group. After application of materials, samples were incubated 2 more days at 37°C and at the end of this period, absorbance values of biofilms were determined and data were analyzed. An increase in microhardness values was Group 2 > Group 3 > Group 1, respectively, but there were no significant differences. After remineralization, microhardness values showed significant increases when compared to demineralized groups, but there was no significant difference. All groups showed decreased absorbance value of biofilm when compared with control group but they were insignificant. It was observed that both in Group 2 and Group 3, glycyrrhizic acid did not have a negative effect on remineralization and although they have an increase, it was insignificant. Although glycyrrhizic acid added CPP-ACP groups showed increased antibacterial activity, they were not statistically significant.
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Affiliation(s)
- Feride Sahin
- Department of Pediatric Dentistry, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
| | - Fatih Oznurhan
- Department of Pediatric Dentistry, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
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9
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Fernando JR, Butler CA, Adams GG, Mitchell HL, Dashper SG, Escobar K, Hoffmann B, Shen P, Walker GD, Yuan Y, Reynolds C, Reynolds EC. The prebiotic effect of CPP-ACP sugar-free chewing gum. J Dent 2019; 91:103225. [DOI: 10.1016/j.jdent.2019.103225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 11/26/2022] Open
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Philip N, Leishman SJ, Bandara HMHN, Walsh LJ. Casein Phosphopeptide-Amorphous Calcium Phosphate Attenuates Virulence and Modulates Microbial Ecology of Saliva-Derived Polymicrobial Biofilms. Caries Res 2019; 53:643-649. [PMID: 31163430 DOI: 10.1159/000499869] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/25/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) acts as a salivary biomimetic that provides bioavailable calcium and phosphate ions to augment fluoride-mediated remineralisation of early caries lesions. However, there are indications that it may also have beneficial ecological effects on the oral microbiome. OBJECTIVE This in vitro study investigated whether CPP-ACP could influence microbial counts, acidogenicity, and the relative abundance of specific caries- and health-associated bacterial -species in polymicrobial biofilms. METHODS Saliva-derived polymicrobial biofilms were grown for 96 h in a cariogenic environment and treated every 12 h with 2% CPP-ACP or vehicle control. Colony forming units (CFUs) and acidogenicity were estimated from the treated biofilms. Microbial ecological effects of CPP-ACP were assessed based on the relative abundance of 14 specific caries- and health-associated -bacterial species using a real-time quantitative PCR assay. -Results: CPP-ACP-treated biofilms showed relatively modest, but significant, reductions in microbial CFUs (21% reduction, p = 0.008) and acidogenicity (33% reduction, p < 0.001), compared to the control-treated biofilms. The CPP-ACP treated biofilms also exhibited significantly lower bacterial loads of cariogenic Scardovia wiggsiae (fold change 0.017, p < 0.001) and Prevotella denticola(fold change 0.005, p < 0.001), and higher bacterial loads of commensal Streptococcus sanguinis(fold change 30.22, p < 0.001), S. mitis/oralis(fold change 9.66, p = 0.012), and S. salivarius/thermophilus(fold change 89.35, p < 0.001) than the control-treated biofilms. CONCLUSIONS The results indicate that CPP-ACP has virulence-attenuating attributes that can influence a beneficial microbial ecological change in the biofilm.
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Affiliation(s)
- Nebu Philip
- The University of Queensland School of Dentistry, Brisbane, Queensland, Australia,
| | - Shaneen J Leishman
- The University of Queensland School of Dentistry, Brisbane, Queensland, Australia
| | - H M H N Bandara
- Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Laurence J Walsh
- The University of Queensland School of Dentistry, Brisbane, Queensland, Australia
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11
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Philip N, Walsh L. The potential ecological effects of casein phosphopeptide-amorphous calcium phosphate in dental caries prevention. Aust Dent J 2018; 64:66-71. [DOI: 10.1111/adj.12661] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2018] [Indexed: 01/20/2023]
Affiliation(s)
- N Philip
- School of Dentistry; The University of Queensland; Brisbane Queensland Australia
| | - L Walsh
- School of Dentistry; The University of Queensland; Brisbane Queensland Australia
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12
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Dashper SG, Shen P, Sim CPC, Liu SW, Butler CA, Mitchell HL, D'Cruze T, Yuan Y, Hoffmann B, Walker GD, Catmull DV, Reynolds C, Reynolds EC. CPP-ACP Promotes SnF 2 Efficacy in a Polymicrobial Caries Model. J Dent Res 2018; 98:218-224. [PMID: 30392434 DOI: 10.1177/0022034518809088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Dental caries is associated with plaque dysbiosis, leading to an increase in the proportions of acidogenic and aciduric bacteria at the expense of alkali-generating commensal species. Stannous fluoride (SnF2) slows the progression of caries by remineralization of early lesions but has also been suggested to inhibit glycolysis of aciduric bacteria. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) promotes fluoride remineralization by acting as a salivary biomimetic that releases bioavailable calcium and phosphate ions, and the peptide complex has also been suggested to modify plaque composition. We developed a polymicrobial biofilm model of caries using 6 bacterial species representative of supragingival plaque that were cultured on sound human enamel and pulsed with sucrose 4 times a day to produce a high cariogenic challenge. We used this model to explore the mechanisms of action of SnF2 and CPP-ACP. Bacterial species in the biofilms were enumerated with 16S rRNA gene sequence analyses, and mineral loss and lesion formation were determined in the enamel directly under the polymicrobial biofilms via transverse microradiography. The model tested the twice-daily addition of SnF2, CPP-ACP, or both. SnF2 treatment reduced demineralization by 50% and had a slight effect on the composition of the polymicrobial biofilm. CPP-ACP treatment caused a similar inhibition of enamel demineralization (50%), a decrease in Actinomyces naeslundii and Lactobacillus casei abundance, and an increase in Streptococcus sanguinis and Fusobacterium nucleatum abundance in the polymicrobial biofilm. A combination of SnF2 and CPP-ACP resulted in a greater suppression of the acidogenic and aciduric bacteria and a significant 72% inhibition of enamel demineralization.
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Affiliation(s)
- S G Dashper
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - P Shen
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - C P C Sim
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - S W Liu
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - C A Butler
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - H L Mitchell
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - T D'Cruze
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - Y Yuan
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - B Hoffmann
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - G D Walker
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - D V Catmull
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - C Reynolds
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - E C Reynolds
- 1 Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, University of Melbourne, Melbourne, Australia
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13
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Jafari K, Hekmatfar S, Fereydunzadeh M. In vitro Comparison of Antimicrobial Activity of Conventional Fluoride Varnishes Containing Xylitol and Casein Phosphopeptide-Amorphous Calcium Phosphate. J Int Soc Prev Community Dent 2018; 8:309-313. [PMID: 30123762 PMCID: PMC6071361 DOI: 10.4103/jispcd.jispcd_67_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/23/2018] [Indexed: 11/04/2022] Open
Abstract
Objective Different fluoride varnishes are used for the prevention of dental caries. The aim of this study was to compare the antimicrobial effect of different fluoride varnishes, containing xylitol and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), on Streptococcus mutans. Materials and Methods In this in vitro study, the antibacterial effects of four varnishes, namely Polimo and V-varnish (containing xylitol), MI varnish (containing CPP-ACP), and Preventa, were evaluated against S. mutans. The disc diffusion method was used for testing the bacterial sensitivity. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U-tests. Results According to the results, Polimo showed the highest antibacterial effects, compared to the other three varnishes (P ≤ 0.05). Growth inhibition zones were not observed in V-varnish and Preventa. The mean diameter of inhibition zone around the MI varnish was significantly higher, compared to those of the V varnish and Preventa (P ≤ 0.05). Conclusion As the findings indicated, the fluoride varnish containing xylitol and CPP-ACP could be more effective iAQ1n the prevention of dental caries.
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Affiliation(s)
- Karim Jafari
- Department of Prosthodontics, Dental Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Somayeh Hekmatfar
- Department of Pedodontics, Dental Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Maryam Fereydunzadeh
- Dental Research Committee, Dental Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
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14
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Shen P, Walker GD, Yuan Y, Reynolds C, Reynolds EC. Polyols and remineralisation of enamel subsurface lesions. J Dent 2017; 66:71-75. [PMID: 28838679 DOI: 10.1016/j.jdent.2017.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/10/2017] [Accepted: 08/16/2017] [Indexed: 11/16/2022] Open
Abstract
Sugar-free chewing gum containing polyols has been demonstrated to reduce caries experience in randomised controlled clinical trials. A range of polyols (mannitol, sorbitol, xylitol and maltitol) can be found in sugar-free gums and it has been claimed that they can facilitate calcium uptake into enamel subsurface lesions promoting remineralisation. OBJECTIVES The aim of this study was to compare the effect of polyols on remineralisation of enamel subsurface lesions in vitro by artificial saliva (AS) and by AS containing the salivary biomimetic casein phosphopeptide amorphous calcium phosphate (CPP-ACP). METHODS The polyols (12.6% w/v) and CPP-ACP (0.376% w/v) were used at physiologically relevant concentrations approximating those released into saliva during chewing a CPP-ACP/polyol chewing gum. Enamel subsurface lesions were exposed to one of the polyols (xylitol, sorbitol, maltitol, mannitol) in AS or AS containing CPP-ACP for 7days at 37°C with a change of solution each day. Remineralisation of the enamel subsurface lesions was measured by transverse microradiography. RESULTS A statistical test for equivalence showed there was no difference in remineralisation between the AS solutions with or without any of the polyols. The AS+CPP-ACP solution substantially promoted remineralisation over AS alone independently of any polyol added. CONCLUSION This controlled in vitro study showed that polyols at physiologically relevant concentrations did not promote remineralisation of enamel subsurface lesions by facilitating calcium uptake into the lesion.
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Affiliation(s)
- Peiyan Shen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Glenn D Walker
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yi Yuan
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Coralie Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eric C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia.
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15
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Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP. Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2016; 116:663-740. [PMID: 28236412 DOI: 10.1016/j.prosdent.2016.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM It is clear the contemporary dentist is confronted with a blizzard of information regarding materials and techniques from journal articles, advertisements, newsletters, the internet, and continuing education events. While some of that information is sound and helpful, much of it is misleading at best. PURPOSE This review identifies and discusses the most important scientific findings regarding outcomes of dental treatment to assist the practitioner in making evidence-based choices. This review was conducted to assist the busy dentist in keeping abreast of the latest scientific information regarding the clinical practice of dentistry. MATERIAL AND METHODS Each of the authors, who are considered experts in their disciplines, was asked to peruse the scientific literature published in 2015 in their discipline and review the articles for important information that may have an impact on treatment decisions. Comments on experimental methodology, statistical evaluation, and overall validity of the conclusions are included in many of the reviews. RESULTS The reviews are not meant to stand alone but are intended to inform the interested reader about what has been discovered in the past year. The readers are then invited to go to the source if they wish more detail. CONCLUSIONS Analysis of the scientific literature published in 2015 is divided into 7 sections, dental materials, periodontics, prosthodontics, occlusion and temporomandibular disorders, sleep-disordered breathing, cariology, and implant dentistry.
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Affiliation(s)
- Terence E Donovan
- Professor, Biomaterials, University of North Carolina School of Dentistry, Chapel Hill, N.C.
| | | | | | - David R Cagna
- Professor, Advanced Prosthodontics University of Tennessee Health Sciences Center, Memphis, Tenn
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16
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Casein Phosphopeptide-Amorphous Calcium Phosphate Reduces Streptococcus mutans Biofilm Development on Glass Ionomer Cement and Disrupts Established Biofilms. PLoS One 2016; 11:e0162322. [PMID: 27589264 PMCID: PMC5010225 DOI: 10.1371/journal.pone.0162322] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/19/2016] [Indexed: 11/19/2022] Open
Abstract
Glass ionomer cements (GIC) are dental restorative materials that are suitable for modification to help prevent dental plaque (biofilm) formation. The aim of this study was to determine the effects of incorporating casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) into a GIC on the colonisation and establishment of Streptococcus mutans biofilms and the effects of aqueous CPP-ACP on established S mutans biofilms. S. mutans biofilms were either established in flow cells before a single ten min exposure to 1% w/v CPP-ACP treatment or cultured in static wells or flow cells with either GIC or GIC containing 3% w/w CPP-ACP as the substratum. The biofilms were then visualised using confocal laser scanning microscopy after BacLight LIVE/DEAD staining. A significant decrease in biovolume and average thickness of S. mutans biofilms was observed in both static and flow cell assays when 3% CPP-ACP was incorporated into the GIC substratum. A single ten min treatment with aqueous 1% CPP-ACP resulted in a 58% decrease in biofilm biomass and thickness of established S. mutans biofilms grown in a flow cell. The treatment also significantly altered the structure of these biofilms compared with controls. The incorporation of 3% CPP-ACP into GIC significantly reduced S. mutans biofilm development indicating another potential anticariogenic mechanism of this material. Additionally aqueous CPP-ACP disrupted established S. mutans biofilms. The use of CPP-ACP containing GIC combined with regular CPP-ACP treatment may lower S. mutans challenge.
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17
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In Vivo Release Kinetics and Antibacterial Activity of Novel Polyphenols-Enriched Chewing Gums. Molecules 2016; 21:molecules21081008. [PMID: 27490529 PMCID: PMC6273284 DOI: 10.3390/molecules21081008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/27/2016] [Accepted: 07/29/2016] [Indexed: 11/17/2022] Open
Abstract
Chewing gums may be particularly effective means for delivering and maintaining bioactive molecules, included in the gum formulation, able to have an anti-cariogenic effect. The purposes of this study were: to develop novel chewing gums containing quercetin (Qt); to evaluate their release using in vivo trial; finally, to test their in vivo antibacterial effect against oral Streptococcus mutans strains. A preliminary study was performed to produce new gums, enriched with the polyphenol quercetin. Then, a first in vivo experimental study was assessed to test the percentages of Qt released in the saliva of young volunteers. Moreover, a second clinical trial was performed to analyze the antibacterial capability of these enriched chewing gums against S. mutans strains after 14 days of daily consumption. The release analysis showed that a more effective release of Qt occurs in the first minutes of chewing, and it does not change saliva pH values. Moreover, Qt included in gums demonstrates an effective antibacterial activity, showing a reduction of the concentration of S. mutans strains in saliva samples, especially after 7 days. Qt included in experimental chewing gums could be efficiently released into the oral cavity and could promote an effective anti-caries concentration in volunteer's saliva, without changing salivary pH values.
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18
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Haghgoo R, Afshari E, Ghanaat T, Aghazadeh S. Comparing the efficacy of xylitol-containing and conventional chewing gums in reducing salivary counts of Streptococcus mutans: An in vivo study. J Int Soc Prev Community Dent 2016; 5:S112-7. [PMID: 26942114 PMCID: PMC4756564 DOI: 10.4103/2231-0762.172947] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: Dental caries is among the most common chronic diseases in humans. Streptococcus mutans is generally responsible for most cases of dental caries. The present study sought to compare the effects of xylitol-containing and conventional chewing gums on salivary levels of S. mutans. Materials and Methods: This study adopted a crossover design. Two type of chewing gums (one containing 70% xylitol and approved by the Iranian Dental Association, and another containing sucrose) were purchased. The participants were 32 individuals aged 18–35 years whose oral hygiene was categorized as moderate or poor based on a caries risk assessment table. Salivary levels of S. mutans were measured at baseline, after the first and second phases of chewing gums, and after the washout period. The measurements were performed on blood agar and mitis salivarius-bacitracin agar (MSBA). Pairwise comparisons were then used to analyze the collected data. Results: Salivary levels of S. mutans in both groups were significantly higher during the two stages of chewing gum than in the washout period or baseline. Moreover, comparisons between the two types of gums suggested that chewing xylitol-containing gums led to greater reductions in S. mutans counts. This effect was more apparent in subjects with poor oral hygiene than in those with moderate oral hygiene. Conclusions: Xylitol-containing chewing gums are more effective than conventional gums in reducing salivary levels of S. mutans in individuals with poor–moderate oral hygiene.
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Affiliation(s)
- Rosa Haghgoo
- Department of Pediatric Dentistry, Shahed University, Tehran, Iran
| | - Elahe Afshari
- Department of Pediatric Dentistry, Shahed University, Tehran, Iran
| | - Tahere Ghanaat
- Department of Pediatric Dentistry, Shahed University, Tehran, Iran
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